6: Problems in pregnancy - small for dates Flashcards Preview

Reproduction Week 3 2018/19 > 6: Problems in pregnancy - small for dates > Flashcards

Flashcards in 6: Problems in pregnancy - small for dates Deck (26)
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1
Q

For what three reasons may a baby be born small?

A

Pre-term delivery

Intrauterine growth restriction

Constitutionally small

2
Q

The earlier in gestation a woman gives birth, the ___ ___ their baby is to survive.

A

earlier = less likely to survive

3
Q

Which growth centile must a foetus be under to be called small for gestational age?

A

10th centile

4
Q

Which measurement can be taken on examination to track foetal growth?

A

Fundus-symphysial height

5
Q

What measurements can be taken on foetal ultrasound to track foetal growth?

A

Abdominal circumference

Femur length

6
Q

If a baby is small for gestational age, by which point should it ideally be delivered?

A

37 weeks

7
Q

Pre-term delivery is also known as ___.

A

prematurity

8
Q

Pre-term delivery is the birth of a child before which point in gestation?

A

Week 37

9
Q

What can trigger pre-term delivery?

A

Illness e.g infection

Over-distension e.g multiple pregnancy, polyhydramnios

Vascular disease - placental abruption

Trauma

10
Q

What measurements can be taken to estimate the growth of a foetus?

A

Fundal height

Estimated foetal weight

On USS: abdominal circumference, femur length

11
Q

What is the definition of a low birth weight?

A

< 2.5kg at any point in gestation

12
Q

Intrauterine growth restriction can be ___ or ___.

A

symmetrical or asymmetrical

symmetrical - genetic disorders

asymmetrical - placental problems

13
Q

Which imaging is used to measure foetal growth during pregnancy?

A

Ultrasound

14
Q

Which foetal ultrasound measurements are used to estimate foetal weight?

A

Abdominal circumference

+/- Femur length

15
Q

Which specific ultrasound scans are used if poor foetal growth is suspected?

A

Uterine artery doppler

MCA scan

16
Q

What underlying disease causes placental infarction and abruption?

A

Maternal hypertension

17
Q

What are some maternal reasons for intra-uterine growth restriction?

A

Lifestyle factors - smoking, alcohol, drug use

Co-morbidities e.g hypertension

Extremes of age

18
Q

What are some foetal reasons for intra-uterine growth restriction?

A

Infection e.g toxoplasmosis, CMV

Congenital abnormalities

Genetic disorders e.g trisomy 21

19
Q

What are some placental reasons for intra-uterine growth restriction?

A

All related to hypertension - infarction, abruption, insufficiency

20
Q

What are the findings of poor foetal growth on examination?

A

Reduced fundal height

Reduced liquour

Reduced foetal movements

21
Q

What are some types of doppler ultrasound scan used in the assessment of foetal wellbeing?

A

Uterine artery doppler

Umbilical artery doppler

MCA scan

22
Q

If a baby is small for dates, when should it be delivered?

A

Week 37

23
Q

Which drugs can be used to help deliver small-for-dates babies?

A

Steroids - speeds up production of pulmonary surfactant

Magnesium sulphate - for neuroprotection

24
Q

What is the purpose of steroids in premature delivery?

A

Increases lung development (production of pulmonary surfactant)

25
Q

What is the purpose of magnesium sulphate in premature delivery?

A

Neuroprotection

26
Q

If a small-for-dates pregnancy is showing signs of static growth or their scans are dodgy, what is indicated?

A

Caesarean delivery

no matter the gestation