Small for Gestational Age Flashcards
what does small for gestational age (SGA) mean?
infant born with birth weight below the tenth centile
AC or EFW <10th centile on USS
what is low birth weight (LBW)?
infant born with birth weight <2500g
what is foetal growth restriction (FGR)?
failure to achieve genetic potential for growth
what is the criteria for FGR?
AC/EFW <3rd centile
OR
AC/EFW <10th centile with evidence of placental dysfunction
what is considered to be evidence of placental dysfunction?
abnormal maternal uterine doppler at 20-24 weeks
abnormal umbilical artery doppler
what SGA foetuses should receive interventions?
below 3rd centile
more likely to have underlying pathology and be truly growth restricted
what are some possible complications of being SGA for the foetus?
still birth
hypoxia
hypoglycaemia
hypothermia
what are some possible complications of being SGA for the mother?
pre-eclampsia
risks in later life
how is SGA diagnosed?
USS measurements of AC and EFW, plotted on a centile chart
what is the management plan once SGA has been identified?
serial scans for growth
umbilical doppler
liquor volume
when should ultrasounds be done for patients with moderate risk factors for SGA?
32 and 36 weeks
when should ultrasounds be done for patients with major risk factors for SGA?
28, 32 and 36 weeks
which patients should be given aspirin in pregnancy and when?
150mg at night from 12 weeks
risk factors for pre-eclampsia or uterine artery notching at anomaly scanning
what advanced doppler studies may be done to investigate SGA?
middle cerebral artery doppler
ductus venosus doppler
when should delivery be aimed for in babies below the 3rd decile?
from 37 weeks - aim to have delivered by 37+6 weeks
