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Repodction > Small for dates pregnancy and pre-term birth > Flashcards

Small for dates pregnancy and pre-term birth Flashcards

1
Q

What is intrauterine growth restriction?

A

Condition where fetus is unable to achieve its genetically determined potential size

(usually below 10th percentile)

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2
Q

Definition of pre-term birth

A

Delivery between 24 and 36+6 weeks

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3
Q

Difference between survival rates of babies born at 24 and 27 weeks?

A

24 weeks - approx 20-30%
27 weeks - 80%
32 weeks - >95%

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4
Q

Risk factors/associations for pre-term birth

A
  • previous PTL (20% risk x1; 40% x2)
  • multiple
  • uterine abnormalities
  • age (teenagers)
  • parity (=0 or >5)
  • ethnicity
  • poor socio-economic status
  • smoking
  • drugs (esp. cocaine)
  • low BMI (
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5
Q

Why might you deliberately have a baby pre-term by cesarean?

A

e. g.
- severe pre-eclampsia
- kidney disease
- poor fetal development (e.g. i think BPS

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6
Q

Fetal exposure to pre-eclampsia is linked to what?

A
  • autism

- developmental delay

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7
Q

How is pre-eclampsia clinically defined?

A

Hypertension and proteinuria, with or without pathologic edema

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8
Q

Infections that could cause poor fetal growth

A

Rubella
CMV
Toxoplasma

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9
Q

Example of congenital anomaly that could cause poor fetal growth

A

Absent kidneys

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10
Q

Example of chromosomal abnormality that could cause poor fetal growth

A

Down’s syndrome

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11
Q

What commonly causes placental problems (and therefore poor growth etc)

A

Often secondary to hypertension!!

e.g. infarcts, abruption

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12
Q

How does placental abruption present?

A

PAINFUL
Bleeding
Uterine contractions
Fetal distress

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13
Q

Is symmetric or asymmetric IUGR more common?

A

Asymmetric

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14
Q

List a couple of causes of asymmetric IUGR

A
  • chronic high BP
  • severe malnutrition
  • genetic mutations (ehler’s danlos)
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15
Q

Post-natal consequences of being growth restricted?

A
  • hypoglycemia
  • effects of asphyxia
  • hypothermia
  • polycythemia
  • hyperbilirubinemia
  • abnormal neurodevelopment
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16
Q

Antenatal/in labour consequences of being growth restricted?

A

Hypoxia and/or death

17
Q

Clinical features of poor growth

A
  • pre-disposing factors
  • reduced liquor
  • reduced movements
  • fundal height less than expected
18
Q

What is cardiotocography?

A

CTG

-way to record fetal heartbeat and uterine contractions

19
Q

How could you assess fetal wellbeing?

A
  • assessment of growth
  • cardiotocography
  • biophysical assessment
  • doppler ultrasound
20
Q

What does an increase in fetal heart rate at the start of a uterine contraction (and then returning to normal before/after contraction) indicate?

A

This indicates good reflex reactivity of the fetal circulation

21
Q

What might cause a loss of baseline variability in a fetal heart rate?

A

Sedative/analgesic drugs (used in labour)

LOSS OF BASELINE VARIABILITY IS BAD

  • greater possibility of asphyxia
  • persistantly minimal or absent FHR variability appears to be the most significant intrapartum sign of fetal compromise
22
Q

What is loss of baseline variability of fetal heart rate?

A

Baseline variability of LESS THAN 5 BEATS PER MINUTE

23
Q

What does the biophysical profile assess?

A
  • movement
  • tone
  • breathing
  • liquor volume
24
Q

Biophysical score 8-10

A

Good

25
Q

Biophysical score 4-6

A

Repeat

26
Q

Biophysical score 0-2

A

Deliver

27
Q

What does the umbilical arterial doppler measure?

A

Measures placental resistance to flow

28
Q

What usually presents first: symmetrical or asymmetrical IUGR?

A

Symmetric usually presents earlier

Asymmetrical usually presents later in the 3rd trimester

29
Q

Causes of symmetric growth restriction?

A

Triploidy 13, triploidy 18, infections e.g. torch

30
Q

Causes of asymmetric IUGR?

A

Placental insufficiency, pre-eclampsia

31
Q

The less baseline variability present, the greater risk of what ?

A

Asphyxia

Repodction (52 decks)

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