Small & Large Births Flashcards

1
Q

What are the 2 main causes for a small baby?

A

Pre-term delivery

Small for gestational age due to intrauterine growth restriction (IUGR) or simply constitutionally small!

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2
Q

How is a birth defined as preterm?

A

Delivery between 24-36 weeks gestation

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3
Q

List some causes of preterm birth

A
Infection
Overdistention (multiple pregnancy)
Placental abruption
Cervical incompetence
Idiopathic
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4
Q

How is a baby defined as being small for gestational age?

A

Birthweight less than 10th centile for gestation, corrected for maternal weight, height, foetal sex and birth order

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5
Q

What maternal factors cause poor growth of a foetus?

A

Lifestyle: smoking, drugs, alcohol
BMI 19 or less
Extremes of age
Disease: hypertension

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6
Q

What foetal factors cause poor growth of a foetus?

A

Infection: rubella, CMV
Congenital anomalies
Chromosomal abnormality

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7
Q

What are the consequences to the foetus if there is growth restriction?

A
Hypoxia
Hypoglycaemia
Asphyxia
Hypothermia
Polycythaemia
Abnormal neurodevelopment
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8
Q

What are some clinical indicators of poor growth?

A

Fundal height less than expected
Reduced liquor
Reduced foetal movements

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9
Q

What is cardiotocography used for?

A

Measure foetal heartbeat

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10
Q

What are the main aetiology behind large babies?

A

Wrong date
Multiple pregnancy
Diabetes
Polyhydramnios

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11
Q

What is polyhydramnios?

A

Excess amniotic fluid

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12
Q

What causes polyhydramnios?

A

Monochorionic twin pregnancy
Foetal anomaly
Diabetes
Hydrops fetalis

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13
Q

What is the difference between zygosity and chorionicity?

A

Zygosity: number of eggs fertilied to produce twins
Chorionicity: membrane pattern of the twins

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14
Q

Which is the outer layer - chorion or amnion?

A

Chorion outside

Amnion inside

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15
Q

Describe a dichorionic diamniotic pregnancy

A

Each foetus has its own amniotic sac and its own placenta

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16
Q

Describe a monochorionic diamniotic pregnancy

A

Each foetus has its own amniotic sac but shared placenta

17
Q

Describe a monochorionic monoamniotic pregnancy

A

Both foetuses share amniotic sac and placenta

18
Q

Multiple pregnancies carry higher perinatal mortality due to what?

A
Congenital anomalies
Preterm labour
Growth restriction
Pre-eclampsia
Twin-twin transfusion
19
Q

How are triplets usually delivered?

A

Caesarean section

20
Q

Describe the pathophysiology of gestational diabetes mellitus

A

Placental hormones cause insulin resistance in the mother, causing hyperglycaemia

21
Q

How does gestational diabetes lead to macrosomia?

A

Overgrowth of insulin sensitive tissues due to hyperinsulinaemia

22
Q

What are the diagnostic glucose values for gestational diabetes (fasting and 2-hour)?

A

Fasting: 5.1 mmol/l or more

2-hour: 8.5 mmol/l or more