Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Y4 Reproductive Health: Antenatal Care > Small for Gestational Age > Flashcards

Small for Gestational Age Flashcards

1
Q

What is small for gestational age (SGA)?

A

Small for gestational age (SGA) is defined as a fetus that measures below the 10th centile for their gestational age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What measurements on USS determine fetal size?

A

Two measurements on ultrasound are used to assess the fetal size:

  • Estimated fetal weight (EFW)
  • Fetal abdominal circumference (AC)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is severe SGA?

A

Severe SGA is when the fetus is below the 3rd centile for their gestational age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is low birth weight?

A

Low birth weight is defined as a birth weight of less than 2500g.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What factors are taken into consideration when using customised growth charts?

A

Customised growth charts are used to assess the size of the fetus, based on the mother’s:

  • Ethnic group
  • Weight
  • Height
  • Parity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What causes SGA?

A

The causes of SGA can be divided into two categories:

  • Constitutionally small, matching the mother and others in the family and growing appropriately on the growth chart
  • Fetal growth restriction (FGR)
    • Also known as intrauterine growth restriction (IUGR)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is fetal growth restriction (FGR)?

A

Fetal growth restriction (FGR), also known as intrauterine growth restriction (IUGR), is when there is a small fetus (or a fetus that is not growing as expected) due to a pathology reducing the amount of nutrients and oxygen being delivered to the fetus through the placenta.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Briefly differentiate between small for gestational age (SGA) and fetal growth restriction (FGR)

A

Small for gestational age simply means that the baby is small for the dates, without stating why. The fetus may be constitutionally small, growing appropriately, and not at increased risk of complications. Alternatively, the fetus may be small for gestational age due to pathology (i.e. FGR), with a higher risk of morbidity and mortality.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the causes of FGR?

A

The causes of fetal growth restriction can be divided into two categories:

  • Placenta mediated growth restriction
  • Non-placenta mediated growth restriction, where the baby is small due to a genetic or structural abnormality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Give examples of causes of placenta mediated growth restriction

A

Placenta mediated growth restriction refers to conditions that affect the transfer of nutrients across the placenta:

  • Idiopathic
  • Pre-eclampsia
  • Maternal smoking
  • Maternal alcohol
  • Anaemia
  • Malnutrition
  • Infection
  • Maternal health conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Give examples of causes of non-placenta medicated growth restriction

A

Non-placenta medicated growth restriction refers to pathology of the fetus, such as:

  • Genetic abnormalities
  • Structural abnormalities
  • Fetal infection
  • Errors of metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What signs would differentiate SGA and FGR?

A

There may be other signs that would indicate FGR other than the fetus being SGA such as:

  • Reduced amniotic fluid volume
  • Abnormal Doppler studies
  • Reduced fetal movements
  • Abnormal CTGs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the short term complications of fetal growth restriction?

A

Short term complications of fetal growth restriction include:

  • Fetal death or stillbirth
  • Birth asphyxia
  • Neonatal hypothermia
  • Neonatal hypoglycaemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the long term complciations of fetal growth restriction?

A

Growth restricted babies have a long term increased risk of:

  • Cardiovascular disease, particularly hypertension
  • Type 2 diabetes
  • Obesity
  • Mood and behavioural problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the risk factors of SGA?

A

There are a long list of risk factors for SGA:

  • Previous SGA baby
  • Obesity
  • Smoking
  • Diabetes
  • Existing hypertension
  • Pre-eclampsia
  • Older mother (over 35 years)
  • Multiple pregnancy
  • Low pregnancy‑associated plasma protein‑A (PAPPA)
  • Antepartum haemorrhage
  • Antiphospholipid syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Briefly describe the monitoring for SGA in low-risk pregnancies

A

The RCOG green-top guidelines on SGA (2013) lists major and minor risk factors. At the booking clinic, women are assessed for risk factors for SGA.

Low-risk women have monitoring of the symphysis fundal height (SFH) at every antenatal appointment from 24 weeks onwards to identify potential SGA. The SFH is plotted on a customised growth chart to assess the appropriate size for the individual woman. If the symphysis fundal height is less than the 10th centile, women are booked for serial growth scans with umbilical artery doppler.

17
Q

When are women booked for serial growth scans with umbilical artery doppler?

A

Women are booked for serial growth scans with umbilical artery doppler if they have:

  • Three or more minor risk factors
  • One or more major risk factors
  • Issues with measuring the symphysis fundal height (e.g. large fibroids or BMI > 35)
18
Q

Briefly describe the moniroting for SGA in high-risk pregnancies

A

Women at risk or with SGA are monitored closely with serial ultrasound scans measuring:

  • Estimated fetal weight (EFW) and abdominal circumference (AC) to determine the growth velocity
  • Umbilical arterial pulsatility index (UA-PI) to measure flow through the umbilical artery
  • Amniotic fluid volume
19
Q

What are the critical management steps for SGA?

A

The critical management steps are:

  • Identifying those at risk of SGA
  • Aspirin is given to those at risk of pre-eclampsia
  • Treating modifiable risk factors (e.g. stop smoking)
  • Serial growth scans to monitor growth
  • Early delivery where growth is static, or there are other concerns
20
Q

When a fetus is identified as SGA, what investigations are used to identify the underlying cause?

A

When a fetus is identified as SGA, investigations to identify the underlying cause include:

  • Blood pressure and urine dipstick for pre-eclampsia
  • Uterine artery doppler scanning
  • Detailed fetal anatomy scan by fetal medicine
  • Karyotyping for chromosomal abnormalities
  • Testing for infections (e.g. toxoplasmosis, cytomegalovirus, syphilis and malaria)
21
Q

Briefly describe the management when growth is statis on a growth chart

A

Early delivery is considered when growth is static on the growth charts, or other problems are identified (e.g. abnormal Doppler results). This reduces the risk of stillbirth. Corticosteroids are given when delivery is planned early, particularly when delivered by caesarean section. Paediatricians should be involved at birth to help with neonatal resuscitation and management if required.

Y4 Reproductive Health: Antenatal Care (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions