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3. Y5 Zero to finals: O&G > Small for Gestational Age > Flashcards

Small for Gestational Age Flashcards

1
Q

What classes a Foetus as Small for Gestational Age?

A

Foetus below 10th centile for their gestational age

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2
Q

What measurements on the US are used to assess foetal size? (2 things)

A
  1. Estimated foetal weight (EFW)
  2. Abdominal circumference (AC)
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3
Q

What measurements are used to see if a foetus is Symmetrically / Assymetrically small? (2 things)

A
  1. Head circumference
  2. Abdominal circumference (AC)
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4
Q

What cause of SGA is Symmetrically small foetus likely to be?

A

Constitutionally small

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5
Q

What cause of SGA is Asymmetrically small foetus likely to be?

A

Placental insuffiency

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6
Q

What features of the mother are used to make Customised Growth Charts for the foetus? (4 things)

A
  1. Ethnic group
  2. Weight
  3. Height
  4. Parity
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7
Q

What is SEVERE SGA?

A

Foetus below 3rd centile for their gestational age

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8
Q

What is Low Birth Weight?

A

Birth weight less than 2500g

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9
Q

What are the causes of SGA? (3 things)

A
  1. Constitutionally Small
  2. Placenta mediated Growth Restriction
  3. Non-placenta mediated Growth Restriction
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10
Q

What does Constitutionally small mean? (2 points)

A
  1. Foetus matches mother + others in family
  2. Growing appropriately on growth chart
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11
Q

What does Placenta mediated Growth restriction refer to?

A

Conditions affecting transfer of nutrients across placenta

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12
Q

What are the causes of Placenta Mediated Growth restriction? (7 things)

A
  1. Idiopathic
  2. Pre-eclampsia
  3. Maternal smoking / alcohol
  4. Anaemia
  5. Malnutrition
  6. Inf
  7. Maternal health conditions
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13
Q

What does Non-Placenta Mediated Growth restriction refer to?

A

Pathology of foetus itself

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14
Q

What are the causes of Non-Placenta Mediated Growth restriction? (4 things)

A
  1. Genetic abn
  2. Structural abn
  3. Foetal inf
  4. Metabolism errors
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15
Q

Other than being SGA, what other signs could indicate Foetal Growth Restriction? (4 things)

A
  1. Reduced amniotic fluid volume
  2. Abn Doppler studies
  3. Reduced foetal movements
  4. Abnormal CTGs
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16
Q

How is Reduced Amniotic fluid volume caused? (3 things)

A
  1. Placental insufficiency
  2. Impaired foetal kidney function
  3. Reduced amniotic fluid volume
17
Q

When should pregnant women be assessed for RF of SGA? (2 times)

A
  1. At booking
  2. At 20 wks
18
Q

What are the RF for SGA? (10 things)

A
  1. Previous SGA baby
  2. Obesity
  3. Smoking
  4. DM
  5. HTN
  6. Pre-eclampsia
  7. Age 35+
  8. Multiple pregnancy
  9. Antepartum haemorrhage
  10. Antiphospholipid syndrome
19
Q

What is the main obv investigation done for SGA?

A

US

20
Q

What other investigations can be done for SGA? (4 things)

A
  1. Detailed foetal anatomical survey
  2. Uterine Artery Doppler (UAD)
  3. Karyotyping
  4. Inf screening
21
Q

What are some Modifiable RF that should be advised about for SGA? (2 things)

A
  1. Smoking cessation
  2. Managing maternal conditions well (e.g DM / HTN)
22
Q

What are women who are at high risk of Pre-eclampsia started on? What’s the time frame?

A
  • 75mg aspirin
  • From 16 weeks till delivery
23
Q

What is the primary surveillance tool for SGA?

A

Uterine Artery Doppler (UAD)

24
Q

How long should you repeat Uterine Artery Doppler (UAD) for SGA? (2 points)

A
  1. Every 14 days if normal
  2. More often if abn
25
Q

When should early delivery of a SGA foetus be considered? (2 things)

A
  1. Growth is static
  2. Other problems (e.g abn Doppler)
26
Q

What is the point of an early delivery of a SGA foetus?

A

Reduces risk of stillbirth

27
Q

What should be given if delivery of a SGA foetus between 24-35+6 weeks is being considered?

A

Single course of antenatal steroids

28
Q

What are the SHORT term complications of SGA? (5 things)

A
  1. Death / stillbirth
  2. Birth asphyxia (brain doesn’t get enough oxygen at birth)
  3. Neonatal hypothermia
  4. Neonatal hypoglycaemia
  5. Polycythaemia
29
Q

What are the LONG term complications of SGA? (4 things)

A
  1. CVS disease (esp HTN)
  2. T2DM
  3. Obesity
  4. Mood / behavioural problems

3. Y5 Zero to finals: O&G (27 decks)

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