UW fetal growth restriction

Question 1

Fetal growth restriction (FGR) is defined as an ultrasound-estimated …? 2

Answer 1

fetal weight <10th percentile OR birth weight <3rd percentile for gestational age

this definition ir for both, symetrical and asymetrical

Question 2

FGR is classified as?

Answer 2

Symmetric FGR and asymetric FGR

Question 3

Symmetric FGR - MCC?

Answer 3

is fetal chromosomal anomalies, followed by first-trimester/congenital infection (eg, toxoplasmosis, cytomegalovirus

Question 4

Asymmetric FGR - causes in general?

Answer 4

Uteroplacental insufficiency, or impaired blood flow through the placenta -> causes the fetus to preserve blood/oxygen to vital organs (eg, brain, heart, placenta) at the expense of less vital organs (eg, abdominal viscera), resulting in head-sparing FGR.

Asymmetric FGR is associated with maternal hypertension and tobacco use during pregnancy

Question 5

Symmetric FGR definition?

Answer 5

A global, proportionate growth lag that uniformly affects fetal organs and often begins in the first trimester from an early insult that inhibits cellular growth and expansion.

Question 6

Asymmetric FGR definition?

Answer 6

is disproportionate growth lag, predominantly affecting the abdominal circumference. (normal head, thin abdomen)

Question 7

Symmetric fetal growth restriction (FGR) begins what trimester?

Answer 7

first

Question 8

Asymmetric FGR occurs what trimester?

Answer 8

second and third

Question 9

Educational objective: Symmetric fetal growth restriction (FGR) begins in the first trimester and is due to fetal conditions such as aneuploidy, congenital anomalies, and intrauterine infection. Asymmetric FGR occurs in the second and third trimesters and is due to maternal conditions that cause placental insufficiency (eg, hypertension).

Answer 9

.

Question 10

Congenital intrauterine infections (eg, toxoplasmosis, cytomegalovirus) are a less common cause of symmetric growth restriction because first-trimester congenital infections are usually so severe that they often result in spontaneous abortion.

If the fetus survives the early infection (particularly through organogenesis), severe malformations will be visualized on the ultrasound (eg, ventriculomegaly, intracerebral calcifications), findings not seen in this patient.

Answer 10

.

Question 11

UW table. symetrical etiology?2

Answer 11

chromocomal abnormalities
congenital infection

Question 12

UW table. saymetrical etiology?2

Answer 12

uteroplacental insufficiency
maternal malnutrition

Question 13

UW table. symetrical CP?1

Answer 13

global growth lag

Question 14

UW table. Asymetrical CP?1

Answer 14

head-sparing growth lag

Question 15

UW table. Mx of both. 4

Answer 15

Regular nonstress testing
weekly biophysical profiles
serial unbilical artery Doppler sonography
Serial growth UG

Question 16

UW table. Evaluation after delivery?

Answer 16

Placenta histopathology
consider karyotype, urine toxycology, serology

Question 17

UW table. neonatal complications? 4

Answer 17

polycythemia
hypoglycemia
hypocalcemia
poor thermoregulation

Question 18

UW table. buvo appearance. 4

Answer 18

Large anterior fontanele
thin unbilical cord
loose, peeling skin
minimal subcutaneous fat