Small for Gestational Age SGA Flashcards
What does “small for gestational age” (SGA) mean?
small for gestational age refers to a fetus or newborn whose weight is below the 10th centile for its gestational age.
How is small for gestational age different from fetal growth restriction (FGR)?
small for gestational age refers to size, while FGR describes a failure to reach genetic growth potential, often due to pathological causes.
What are the causes of small for gestational age?
Causes include maternal factors (e.g., malnutrition, smoking), fetal factors (e.g., chromosomal abnormalities), and placental insufficiency.
What are the maternal risk factors for small for gestational age?
Risk factors include advanced maternal age, smoking, substance abuse, chronic hypertension, pre-eclampsia, and previous small for gestational age pregnancies.
What fetal conditions can lead to small for gestational age?
Conditions include chromosomal abnormalities (e.g., trisomy 21), genetic syndromes, and congenital infections (e.g., TORCH infections).
What placental factors contribute to small for gestational age?
Placental insufficiency, placental abruption, and abnormal cord insertion (e.g., velamentous cord) are key contributors.
How is small for gestational age diagnosed?
Diagnosis involves measuring symphysis-fundal height (SFH) and confirming with ultrasound biometry to assess fetal size and growth.
What ultrasound parameters are used to assess fetal growth?
Parameters include abdominal circumference (AC), head circumference (HC), femur length (FL), and estimated fetal weight (EFW).
What additional investigations are used in small for gestational age?
Doppler studies of the umbilical artery, maternal blood tests (e.g., TORCH screen), and fetal karyotyping may be performed.
What is the role of Doppler studies in small for gestational age?
Doppler studies assess placental function and blood flow, helping to identify fetal hypoxia or placental insufficiency.
What are the classifications of small for gestational age?
small for gestational age is classified as either symmetrical (proportional growth restriction) or asymmetrical (disproportionate growth restriction).
What is the difference between symmetrical and asymmetrical small for gestational age?
Symmetrical small for gestational age affects all fetal parameters equally, often due to early insults, while asymmetrical small for gestational age spares head growth, often due to placental insufficiency.
What complications are associated with small for gestational age?
Complications include hypoglycaemia, hypothermia, perinatal asphyxia, meconium aspiration, and long-term developmental delays.
How is small for gestational age managed antenatally?
Management includes regular growth scans, Doppler monitoring, and maternal lifestyle optimisation (e.g., smoking cessation).
What are the indications for delivery in small for gestational age?
Indications include abnormal Doppler studies, maternal complications (e.g., pre-eclampsia), or evidence of fetal compromise.
What are the delivery considerations for small for gestational age babies?
Mode and timing depend on fetal and maternal condition; caesarean section may be required for fetal distress or abnormal Doppler studies.
How is small for gestational age managed immediately after birth?
Management includes monitoring temperature, blood glucose, and signs of hypoxia, as well as providing nutritional support if needed.
What are the long-term outcomes for small for gestational age babies?
Long-term outcomes may include developmental delays, learning difficulties, and an increased risk of chronic conditions like diabetes and hypertension.
How can maternal lifestyle changes help prevent small for gestational age?
Smoking cessation, balanced nutrition, avoiding alcohol, and managing chronic conditions can reduce the risk of small for gestational age.
What is the role of aspirin in small for gestational age prevention?
Low-dose aspirin is recommended for high-risk women to reduce the risk of placental insufficiency and pre-eclampsia.
How does maternal malnutrition contribute to small for gestational age?
Malnutrition limits the supply of essential nutrients for fetal growth, leading to growth restriction.
How does smoking affect fetal growth?
Smoking reduces placental blood flow and oxygen delivery, increasing the risk of small for gestational age.
What congenital infections are associated with small for gestational age?
TORCH infections (toxoplasmosis, rubella, cytomegalovirus, herpes simplex) can impair fetal growth and development.
What is the significance of abnormal umbilical artery Doppler in small for gestational age?
Abnormal Doppler studies indicate placental insufficiency and increased risk of fetal hypoxia, guiding the timing of delivery.
What is the importance of monitoring fetal movements in small for gestational age?
Reduced fetal movements may indicate fetal compromise and require immediate assessment.
How is neonatal hypoglycaemia managed in small for gestational age babies?
Management involves early and frequent feeding, glucose monitoring, and intravenous glucose if severe hypoglycaemia occurs.
What is the importance of follow-up for small for gestational age infants?
Regular follow-up ensures monitoring of growth, development, and management of any long-term complications.
