Small for Gestational Age Flashcards
What is the definition of Small for Gestational Weight (SGA)?
Abdominal Circumference (AC) of estimated foetal weight (EFW) less than 10th centile.
What is the definition of Foetal Growth Restriction?(FGR)
- Failure of the Foetus to attain their growth potential.
- All babies below 3rd centile.
- Below 10th centile with evidence of placental dysfunction.
What is the definition of Low Birth weight? (LBW)
Any baby born less than 2.5kg at any gestation.
What are the potential complications of FGR and SGA in the Antenatal and Labour periods?
Hypoxia
Still birth
What are the potential complications of FGR and SGA in the Postnatal period?
Hypoglycaemia
Asphyxia
Hypothermia
Polycythemia
Hyperbilirubinaemia
Abnormal Neurodevelopment
Prematurity
What are the Maternal Causes of SGA?
Lifestyle: smoking, alcohol and drugs.
Very low or High BMI
Age
Maternal disease - e.g. HyperT, Renal disease, Anti-Phosph Synd!
Daily Vigorous Exercise.
What are the Placental causes of SGA?
Infarctions.
Abruption (APH).
Assoc with HyperT diseases (PET, GH)
What are the Foetal causes of SGA?
Infection e.g. Rubella, CMV, Toxoplasmosis.
Congenital Abnormalities.
Chromosomal Abnormalities.
How is SGA prevented?
Aspirin for those at risk of Pre-eclampsia.
Vit D sups for all.
Smoking Cessation. (stop before 15 wks)
Drugs problems service input.
LMWH in those with Antiphospholipid Synd.
What scanning is done if there are R.Factors for SGA?
Uterine Artery Doppler scan usually done at Anomaly scan.
Depending on this:
Moderate Risk Factors + Normal Uterine Artery Doppler = Serial USS from 32 wks every 4 wks until delivery.
High Risk Factors + Normal UAD = Serial USS from 32 wks every 2-4 wks.
High Risk Factors + Abnormal UAD But EFW ≥10th centile = Serial USS from 28wks every 2-4 wks.
High Risk Factors + Abnormal UAD and AC or EFW < 10th centile = Discussion with foetal medicine team.
What are the advantages/disadvantages of measuring Symphysis - Foetal Height?
Advantage: Cheap, easy and available, better if continuity of carer.
Disadvantages: User variation, poor quality evidence for benefit.
Only really done in Low risk pregnancy to plot on centile chart from wk 24.
When should a Growth scan be conducted in measurements of SFH?
If a single measurement happens to be below 10th centile, static growth or crossing centiles. (low threshold)
What Measurements are made during Ultrasound of the Foetus?
Abdominal Circumference.
Head Circumference.
Femur Length.
All these measurements are combined to give EFW.
What is actually Measured in Umbilical Artery Doppler?
Pulsatility Index (PI) measured, varies with gestation.
(reduces as gestation advances) (<1.4 always normal)
What does a Middle Cerebral Artery Doppler investigate?
Indicates brain perfusion.
The redistrobution of blood to vital organs - such as brain.
Reduced PI in a compromised foetus.
Useful additional marker in SGA/FGR after 32 weeks.
