Small for dates pregnancy

Question 1

Definition of pre-term birth

Answer 1

Birth between 24-36+6 weeks gestation

Question 2

Causes of pre-term birth (6)

Answer 2

Infection
Over-distension (multiple pregs, polyhydramnios)
Placental abruption
Cervical incompetence
Intercurrent illness
Idiopathic

Question 3

Definition of small for gestational age

Answer 3

Birthweight less than 10th centile

Question 4

Complications of being SGA (4)

Answer 4

Stillbirth
Hypoxia
Neonatal complications
Impaired neurodevelopment

Question 5

Methods of assessing growth (2)

Answer 5

Symphyseal-fundal height

Ultrasound (est. foetal weight and abdominal circumference)

Question 6

How can foetal well-being be assessed?

Answer 6

Cardiotocography

Question 7

What are the “reassuring” patterns on CTG? (4)

Answer 7

Rate 110-160
Baseline variability 5-25bpm
Accelerations associated with movements/contractions

Question 8

What is a worrying sign on CTG?

Answer 8

Late decelerations

Question 9

Which metrics does the biophysical profile measure? (4)

Answer 9

Movement
Tone
Foetal breathing movements
Liquor volume

Question 10

What does umbilical artery Doppler measure?

Answer 10

Flow in the umbilical artery; absent or reduced end-diastolic flow suggests placental resistance and is an ominous sign

Question 11

When does foetal weight gain/growth tend to accelerate/decelerate?

Answer 11

Around 10 weeks; growth rate diminishes before term

Question 12

What are the factors which determine foetal birth weight? (4)

Answer 12

Gestational age; race; maternal height and weight; parity

Question 13

What are the two categories of small for gestational age babies?

Answer 13

Constitutionally small

Intra-uterine growth restriction