Small for Gestational Age

Question 1

What defines SGA and what makes it severe?

Answer 1

Estimated foetal weight or abdominal circumference <10th percentile

<3rd percentile = severe

Birth weight of <2.5kg = FGR

Question 2

All mothers have the same set estimated growth chart. T/F?

Answer 2

F - personalised based on mothers size and ethnicity

Question 3

Name some of the major risks of SGA

Answer 3

Previous SGA
Pre-eclampsia
Maternal age >40
Smoker and drinker

Question 4

what are the two categories of cause for SGA?

Answer 4

Constitutionally small

• appropriate for mother and ethnicity
• most common

Fetal growth restriction
- due to placental and non-placental pathology

Question 5

Why can maternal HTN lead to foetal growth restriction (FGM)?

Answer 5

HTN can cause placenta infarcts which prevent the baby from getting O2 and nutrients it needs

Question 6

When is symphysis-fundal height (SFH) first measured?

When would a mother qualify for serial growth scans w/umblilical artery doppler?

Answer 6

24 weeks

1 major risk
3 minor
1 measurement <10th percentile

Question 7

In umbilical artery doppler what should blood flow from mother to baby look like when mother is in diastole?

Answer 7

Should always be forward flowing

Question 8

What is used to assess EFW and AC?

Answer 8

USS - key investigation tool

Question 9

If a baby is SGA what further invx can be run to identify cause?

Answer 9

Karyotyping - chromosomal

Uterine artery doppler scan - bloodflow

Infection test

BP and urine dipstick - pre-eclampsia

Question 10

If there is a high risk of pre-eclampsia or presence of uterine artery notching what drug should be given?

Answer 10

150mg aspirin at night

Question 11

What are the complications of SGA in particular severe?

Answer 11

Still birth
Longterm disability
Antenatal/intrapartum asphyxia

Question 12

Early delivery can be considered if static growth or abnormal doppler scans at what time frame is this considered for SGA and severe SGA?

What drug is given before hand?

Answer 12

Severe - 37wks
SGA - 39wks

beclomethasone to be given

Question 12

Early delivery can be considered if static growth or abnormal doppler scans at what time frame is this considered for SGA and severe SGA?

What drug is given before hand?

Answer 12

Severe - 37wks
SGA - 39wks

Corticosteroids to be given

Question 13

What can cause placental and non-placental causes of SGA?

Answer 13

Placental

• mother health conditions e.g. HTN
• infections
• smoking and drinking
• pre-eclampsia

Non-placental

• foetal infection
• chromosomal
• structural

Question 13

What can cause placental and non-placental causes of SGA?

Answer 13

Placental

• mother health conditions e.g. HTN
• infections
• smoking and drinking
• pre-eclampsia

Non-placental

• foetal infection
• chromosomal
• structural

Question 14

What weight at term indicates FGR?

Answer 14

<2.5kg

Question 15

What weight at term indicates FGR?

Answer 15

<2.5kg