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Neonatal > Small for Gestational Age > Flashcards

Small for Gestational Age Flashcards

1
Q

What is the definition for small for gestational age?

A

A fetus that measures below the 10th centile for their gestational age.

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2
Q

What measurements on ultrasound are used to assess fetal size?

A
  • Estimated fetal weight (EFW)

* Fetal abdominal circumference (AC)

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3
Q

What is severe SGA?

A

When the fetus is below the 3rd centile for their gestational age.

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4
Q

What are the 2 categories for the causes of SGA?

A

Constitutionally small

Fetal growth restriction (FGR),

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5
Q

What does constitutionally small mean?

A

Match the mother and others in the family, and growing appropriately on the growth chart

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6
Q

What is another term for fetal growth restriction/

A

Intrauterine growth restriction

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7
Q

What is fetal growth restriction?

A

A small fetus (or a fetus that is not growing as expected) due to a pathology reducing the amount of nutrients and oxygen being delivered to the fetus through the placenta

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8
Q

What can fetal growth restriction be divided into?

A
  • Placenta mediated growth restriction

* Non-placenta mediated growth restriction

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9
Q

What is non-placental mediated growth restriciton?

A

Baby is small due to a genetic or structural abnormality

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10
Q

What does placental mediated growth restriction refer to?

A

Conditions that affect the transfer of nutrients across the placenta

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11
Q

What are examples of placental mediated growth restrictions?

A
  • Idiopathic
  • Pre-eclampsia
  • Maternal smoking
  • Maternal alcohol
  • Anaemia
  • Malnutrition
  • Infection
  • Maternal health conditions
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12
Q

What are examples of non-placental mediated growth restrictions Pathology of the fetus)?

A
  • Genetic abnormalities
  • Structural abnormalities
  • Fetal infection
  • Errors of metabolism
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13
Q

What are other signs of fetal growth restriction that aren’t SGA?

A
  • Reduced amniotic fluid volume
  • Abnormal Doppler studies
  • Reduced fetal movements
  • Abnormal CTGs
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14
Q

What are possible short term complications of fetal growth restriction?

A
  • Fetal death or stillbirth
  • Birth asphyxia
  • Neonatal hypothermia
  • Neonatal hypoglycaemia
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15
Q

What are possible long term complications of growth restricted babies?

A
  • Cardiovascular disease, particularly hypertension
  • Type 2 diabetes
  • Obesity
  • Mood and behavioural problems
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16
Q

What are possible risk factors for SGA?

A
  • Previous SGA baby
  • Obesity
  • Smoking
  • Diabetes
  • Existing hypertension
  • Pre-eclampsia
  • Older mother (over 35 years)
17
Q

What is the monitoring for low risk women?

A

Monitoring of the symphysis fundal height (SFH) at every antenatal appointment from 24 weeks onwards to identify potential SGA

18
Q

What is the management of a woman if the symphysis fundal height is less than the 10th centile?

A

Women are booked for serial growth scans with umbilical artery doppler

19
Q

When are women booked for serial growth scans with umbilical artery doppler?

A

They are booked for scans with an umbilical artery doppler if:
• Three or more minor risk factors
• One or more major risk factors
• Issues with measuring the symphysis fundal height (e.g. large fibroids or BMI > 35)

20
Q

When a fetus is identified as SGA what investigations can be done to identify the underlying cause?

A
  • Blood pressure and urine dipstick for pre-eclampsia
  • Uterine artery doppler scanning
  • Detailed fetal anatomy scan by fetal medicine
  • Karyotyping for chromosomal abnormalities
  • Testing for infections (e.g. toxoplasmosis, cytomegalovirus, syphilis and malaria)
21
Q

What is considered when the growth is static on the growth charts?

A

Early delivery

22
Q

Why is early delivery considered for fetus with SGA?

A

Reduces the chance of stillbirth

23
Q

What medication needs to be given with a fetus affected by SGA during delivery?

A

Corticosteroids

Neonatal (37 decks)

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