Small & Large Births Flashcards
What are the 2 main causes for a small baby?
Pre-term delivery
Small for gestational age due to intrauterine growth restriction (IUGR) or simply constitutionally small!
How is a birth defined as preterm?
Delivery between 24-36 weeks gestation
List some causes of preterm birth
Infection Overdistention (multiple pregnancy) Placental abruption Cervical incompetence Idiopathic
How is a baby defined as being small for gestational age?
Birthweight less than 10th centile for gestation, corrected for maternal weight, height, foetal sex and birth order
What maternal factors cause poor growth of a foetus?
Lifestyle: smoking, drugs, alcohol
BMI 19 or less
Extremes of age
Disease: hypertension
What foetal factors cause poor growth of a foetus?
Infection: rubella, CMV
Congenital anomalies
Chromosomal abnormality
What are the consequences to the foetus if there is growth restriction?
Hypoxia Hypoglycaemia Asphyxia Hypothermia Polycythaemia Abnormal neurodevelopment
What are some clinical indicators of poor growth?
Fundal height less than expected
Reduced liquor
Reduced foetal movements
What is cardiotocography used for?
Measure foetal heartbeat
What are the main aetiology behind large babies?
Wrong date
Multiple pregnancy
Diabetes
Polyhydramnios
What is polyhydramnios?
Excess amniotic fluid
What causes polyhydramnios?
Monochorionic twin pregnancy
Foetal anomaly
Diabetes
Hydrops fetalis
What is the difference between zygosity and chorionicity?
Zygosity: number of eggs fertilied to produce twins
Chorionicity: membrane pattern of the twins
Which is the outer layer - chorion or amnion?
Chorion outside
Amnion inside
Describe a dichorionic diamniotic pregnancy
Each foetus has its own amniotic sac and its own placenta
Describe a monochorionic diamniotic pregnancy
Each foetus has its own amniotic sac but shared placenta
Describe a monochorionic monoamniotic pregnancy
Both foetuses share amniotic sac and placenta
Multiple pregnancies carry higher perinatal mortality due to what?
Congenital anomalies Preterm labour Growth restriction Pre-eclampsia Twin-twin transfusion
How are triplets usually delivered?
Caesarean section
Describe the pathophysiology of gestational diabetes mellitus
Placental hormones cause insulin resistance in the mother, causing hyperglycaemia
How does gestational diabetes lead to macrosomia?
Overgrowth of insulin sensitive tissues due to hyperinsulinaemia
What are the diagnostic glucose values for gestational diabetes (fasting and 2-hour)?
Fasting: 5.1 mmol/l or more
2-hour: 8.5 mmol/l or more
