SGA and IUGR Flashcards
What is the definition of small for gestational age?
Weight of foetus is <10th centile for its gestation.
What are the two causes of a foetus being small for gestational age?
- Constitutionally small and grown consistently
2. Growth restricted (IUGR)
What is intrauterine growth restriction (IUGR)?
Foetus failed to reach their own ‘growth potential’.
What are the causes of SGA/IUGR?
- Constitutional deformities - low maternal weight/height, nulliparity, Asian, female foetus.
- Pathological determinants - renal disease, DM, autoimmune disease, pre-eclampsia, smoking, drug use, extreme exercise, malnutrition.
- Foetal factors - congenital chromosomal abnormalities, CMV infection, multiple pregnancy.
How can you confirm that a baby small for gestational age has IUGR?
- Abnormal umbilical artery doppler suggests placental dysfunction.
- Combined with middle cerebral artery doppler after 34/40 to make cerebroplacental ratio.
What is the diagnostic feature of IUGR versus SGA?
- Reduction in growth velocity by >30% suggests IUGR.
2. If abdomen and head are small in proportion to each other, this suggests SGA only.
What is the preterm management of SGA?
Recheck growth with USS every 2 weeks.
What is the term management of SGA?
Deliver, but is >3rd centile with normal umbilical artery and MCA dopplers, wait till 40/40.
How is IUGR managed if dopplers are normal?
- Review USS 2x per week
2. Aim for induction of labour or C-section at 37/40
How is IUGR managed if dopplers are abnormal (absent/reversed end-diastolic flow in umbilical artery?
- Review USS 2x per week
- Admit
- Steroids and magnesium if <34/40
- If >32/40 - deliver by C-section
- If <32/40 - daily CTG, if abnormal CTG, deliver by C-section
What are the effects on adults born after IUGR?
Higher risk of HTN, CAD, T2DM, and autoimmune thyroid disease.
