The Small Baby Flashcards
Small for gestational age (SGA) - when estimated foetal weight is below ___ centile
below 10th gentile
Intra uterine growth restriction (IUGR)
Failure to achieve growth potential in utero
Which of the following is the foetus most likely to be seen crossing centiles : SGA or IUGR?
IUGR
IUGR - antenatal risks
Hypoxia or death
IUGR - post natal risks
Hypoglycaemia
Hypothermia
Abnormal neurodevelopment
Developmental delay
IUGR will not cause problems in later life. True or false?
False
Low birth weight (LBW) is weight below ___ regardless of gestation
below 2.5kg
At which gestation is delivery classed as “preterm delivery”
Before 37 weeks
Preterm delivery - moderate/late
32 –> 36+6 weeks gestation
Preterm delivery - very preterm
28 –> 31+6 weeks gestation
Preterm delivery - extreme preterm
24 –> 27+6 weeks gestation
Risk factors for preterm birth
Previous pre-term labour Multiple pregnancy Uterine anomalies Age (teenagers) Parity =0 or >5 Smoking Drugs Low BMI Poor socio economic status
How do we identify a SGA foetus?
During screening at booking appointment
- CRL of baby
During subsequent antenatal appointments
SGA baby - how many MAJOR and MINOR antenatal risk factors are required for the patient to get serial growth scans?
1 major risk factor
or
at least 3 minor risk factors
SGA baby - if there is a MAJOR antenatal risk factor, how often do you need to scan baby?
Every 4 weeks until delivery from week 26-28
SGA baby - if there are MINOR risk factors present then when do you do a follow up scan?
34 weeks
How do you diagnose SGA?
Screening tests (SFH) Measurement of foetal abdominal circumference. - combine this with head circumference +/- femur length to give estimated foetal weight.
What does amniotic fluid index tell you?
How well the baby is producing urine
What is the primary tool used to assess a SGA baby?
Umbilical artery doppler US
When assessing a SGA baby, if umbilical artery doppler is normal, what do you do?
MCA doppler when baby is between 32-37 weeks
Causes of SGA baby - maternal factors
Lifestyle - smoking, alcohol, drugs
Height and weight
Age
Maternal disease
Causes of SGA baby - placental factors
Placental abruption
Infarction
Causes of SGA baby - foetal factors
Infection
Congenital anomalies
Chromosome abnormalities
The earlier an SGA baby is picked up, the higher/lower the concern about potential chromosomal abnormality?
Higher
