small for gestational age Flashcards
SGA defined as
measures below 10th centile for gestational age
severe SGA
< 3rd centile for gestatinal age
low birth weight
< 2500g
categories of SGA
contitutionally small
fetal growth restriction/IUGR
fetal growth restriction aka IUGR
small fetus due to pathology reducing amount of nutrients and oxygen delivered through placenta
IUGR - placenta mediated growth restriction
conditions that affect transfer of nutrients across placenta
IUGR - placenta mediated growth restriction - causes
idiopathic PET maternal smoking maternal alcohol anaemia malnutrition maternal infection maternal health conditions
IUGR - non-placenta mediated growth restriction
pathology of fetus
IUGR - non-placenta mediated growth restriction - causes
genetic abnormalities
structural abnormalities
fetal infection
erros of metabolism
other signs of IUGR other than SGA
oligohydramnios
abnormal doppler studies
reduced fetal movements
abnormal CTGs
IUGR - short term complicatins
fetal death or stillbirth
birth asphyxia
neonatal hypothermia
neonatel hypoglycaemia
growth restricted babies have long term increased risk of…
CVS disease esp hypertension
T2DM
obesity
mood + behaviour Sx
SGA risk factors
previous SGA baby obesity smoking diabetes htn PET older mum multiple pregnancy low PAPP APH antiphospholipid syndrome
monitoring - low risk women
measure sympheseal fundal height at every appt from 24wks
if < 10th centile then booked for serial groth scans
women are booked for serial growth scans if
3+ minor risk factors
1+ major risk factors
serial USS measure
estimated fetal weight + abdo circumfrence
umbilical arterial pulsality index
amniotic fluid volume
Mx - critical steps
- identify those at risk of SGA
- aspirin to those at risk of PET
- Rx modifiable risk factors e.g. X smoking
- serial growth scans
- early delivery if static growth/other concerns
when is early delivery considered
growth or static on growth charts
or
other problem identified e.g. abnormal doppler results
steroids given if early CS
