Small for Dates

Question 1

Term for small for dates?

Answer 1

Small for gestational Age

SGA

Question 2

What is SGA?

Answer 2

Infant born with birth weight below the 10th centile

Question 3

How is SGA picked up?

Answer 3

Because abdominal circumference or estimated fetal weight on US is below 10th centile

Question 4

Low birth weight?

Answer 4

Infant with birth weight <2500g at any gestation

Question 5

LBW goes hand in hand with SGA? True or false?

Answer 5

False

premature baby may have low birth weight but be an appropriate wt for its gestation

Question 6

FGR?

Answer 6

Fetal growth restriction

Question 7

What is FGR?

Answer 7

Failure to achieve genetic potential for growth, this implies pathological restriction of genetic growth potential

Question 8

What should interventions be targeted to in SGA?

Answer 8

Below 3rd centile as these are more likely to have underlying pathology

Question 9

Categories of causes of SGA?

Answer 9

Constitutionally small
Placental
Fetal
Maternal

Question 10

Placental causes of SGA?

Answer 10

Infarcts

Abruption

Question 11

Fetal causes of SGA?

Answer 11

Infection (CMV, rubella, congenital anomalies, chromosomal abnormalities)

Question 12

Maternal causes of SGA?

Answer 12

Lifestyle, age, maternal disease

Question 13

Constitutionally small cause of SGA means?

Answer 13

Mum and da are small

Small baba

Question 14

Importance of identifying SGA?

Answer 14

Greater perinatal morbidity and mortality: antenatal and intrapartum hypoxia, hypoglycaemia, hypothermia, polycythaemia, hyperbilirubinemia
May need preterm delivery
SGA may be initial presentation of maternal disease (PEclam)

Question 15

Major RF for SGA?

Answer 15

Abnormal uterine artery doppler at 20 weeks

Question 16

What happens to women who have SFH measurements below 10th centile?

Answer 16

Referred for serial growth scan

Question 17

How is SGA diagnosed?

Answer 17

US measurement of AC (abdo circumf)
BPD (biparietal diameter) 
Femoral length (EFW)

Question 18

If woman has factors meaning SFH might not be accurate?

Answer 18

Referred for US to monitor foetal weight

Question 19

Factor indicating SFH measurements inaccuracy?

Answer 19

Fibroids

BMI > 35

Question 20

Minimum management of SGA?

Answer 20

Serial growth scans with umbilical doppler and liquor volume (amniotic fluid)

Question 21

Medical managemnet of SGA?

Answer 21

150mg aspirin at night from 12 weeks with women who have RF for Pre-ec or

Question 22

If baby is below 3rd centile what should you offer in terms of delivery?

Answer 22

Delivery from 37 weeks (aim for before 38th week)

Question 23

If baby is between 3-10th centile offer delivery when?

Answer 23

39 weeks

Question 24

Abnoraml umbilical doppler can mean what and should what the be offered?

Answer 24

Can mean: increased chance of foetal distress in labour

Offer: c section

Question 25

What can be offered below 32 weeks to protect against cerebral palsy?

Answer 25

Mg Sulfate

Question 26

Why do earlier deliveries in SGA?

Answer 26

Stats show weeks 37-39 is safer as still term anyway and there is risk of placental insufficiency etc so better to get them out earlier