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Reproduction SOH > The Small Baby > Flashcards

The Small Baby Flashcards

1
Q

Small for gestational age (SGA) - when estimated foetal weight is below ___ centile

A

below 10th gentile

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2
Q

Intra uterine growth restriction (IUGR)

A

Failure to achieve growth potential in utero

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3
Q

Which of the following is the foetus most likely to be seen crossing centiles : SGA or IUGR?

A

IUGR

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4
Q

IUGR - antenatal risks

A

Hypoxia or death

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5
Q

IUGR - post natal risks

A

Hypoglycaemia
Hypothermia
Abnormal neurodevelopment
Developmental delay

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6
Q

IUGR will not cause problems in later life. True or false?

A

False

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7
Q

Low birth weight (LBW) is weight below ___ regardless of gestation

A

below 2.5kg

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8
Q

At which gestation is delivery classed as “preterm delivery”

A

Before 37 weeks

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9
Q

Preterm delivery - moderate/late

A

32 –> 36+6 weeks gestation

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10
Q

Preterm delivery - very preterm

A

28 –> 31+6 weeks gestation

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11
Q

Preterm delivery - extreme preterm

A

24 –> 27+6 weeks gestation

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12
Q

Risk factors for preterm birth

A 
Previous pre-term labour 
Multiple pregnancy 
Uterine anomalies 
Age (teenagers) 
Parity =0 or >5 
Smoking
Drugs 
Low BMI 
Poor socio economic status
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13
Q

How do we identify a SGA foetus?

A

During screening at booking appointment
- CRL of baby

During subsequent antenatal appointments

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14
Q

SGA baby - how many MAJOR and MINOR antenatal risk factors are required for the patient to get serial growth scans?

A

1 major risk factor
or
at least 3 minor risk factors

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15
Q

SGA baby - if there is a MAJOR antenatal risk factor, how often do you need to scan baby?

A

Every 4 weeks until delivery from week 26-28

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16
Q

SGA baby - if there are MINOR risk factors present then when do you do a follow up scan?

A

34 weeks

17
Q

How do you diagnose SGA?

A 
Screening tests (SFH) 
Measurement of foetal abdominal circumference.
- combine this with head circumference +/- femur length to give estimated foetal weight.
18
Q

What does amniotic fluid index tell you?

A

How well the baby is producing urine

19
Q

What is the primary tool used to assess a SGA baby?

A

Umbilical artery doppler US

20
Q

When assessing a SGA baby, if umbilical artery doppler is normal, what do you do?

A

MCA doppler when baby is between 32-37 weeks

21
Q

Causes of SGA baby - maternal factors

A

Lifestyle - smoking, alcohol, drugs
Height and weight
Age
Maternal disease

22
Q

Causes of SGA baby - placental factors

A

Placental abruption

Infarction

23
Q

Causes of SGA baby - foetal factors

A

Infection
Congenital anomalies
Chromosome abnormalities

24
Q

The earlier an SGA baby is picked up, the higher/lower the concern about potential chromosomal abnormality?

A

Higher

25
Q

If all is well with pregnancy, when should you aim to deliver baby?

A

By week 37

26
Q

If the baby is below 10th gentile but everything else in pregnancy is normal, when should you aim to deliver baby?

A

By week 37

27
Q

If the baby has static growth (i.e. not much change in the baby over a period of time), how should you deliver it?

A

Caesarean section

28
Q

If there is abnormality on the umbilical artery doppler, what should you do?

A

Deliver baby by caesarean section

29
Q

If there is a normal umbilical artery doppler but abnormal MCA doppler, what should you do?

A

Delivery baby by caesarean section

30
Q

What is the role of steroids in the small baby?

A

Give steroids up to 36 weeks gestation to promote foetal lung maturity

31
Q

Who gets magnesium sulphate?

A

Women at risk of pre-term delivery

32
Q

What is the role of magnesium sulphate in preterm delivery?

A

Provides foetal neural development and lowers the risk of cerebral palsy

33
Q

Up to which gestation can you give magnesium sulphate?

A

Up to 32 weeks gestation

Reproduction SOH (50 decks)

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