Foetal growth restriction

Question 1

What is small for gestational age defined as?

Answer 1

<10th centile for GA

Question 2

How is size for gestational age measured

Answer 2

Estimated foetal weight (EFW)
Foetal abdominal circumference (AC)

Question 3

What are growth charts customised on>

Answer 3

Ethnic group, weight, height, parity

Question 4

Severe SGA vs low BW

Answer 4

< 3rd centile
low BW - <2500g

Question 5

What is given to those at risk of pre eclampsia?

Answer 5

Aspirin

Question 6

Tests for SGA cuaes

Answer 6

BP and urine dipstick for pre-eclampsian
Uterine artery doppler scanning
Detailed foetal anatomy scan by foetal medicine
Kayotyping for chromosomal abnormalities
Testing for infections (eg toxoplasmosis, cytomegalovirus, syphilis and malaria)

Question 7

Causes of SGA

Answer 7

Maternal - prepregnancy weight, undernutrition, substance abuse or severe anaemia.
pre-eclampsia, autoimmune disease, thrombophilias, renal disease, diabetes and essential hypertension.

Question 8

Types of SGA

Answer 8

normal (constitutionally) small, non–placenta-mediated growth restriction (for example: structural or chromosomal anomaly, inborn errors of metabolism and fetal infection) and placenta mediated growth restriction.

Question 9

Surveillance for women with risks for SGA

Answer 9

All women should be assessed at booking for risk factors for a SGA fetus/neonate to identify those who
require increased surveillance.
Women who have a major risk factor should be referred for serial ultrasound
measurement of fetal size and assessment of wellbeing with umbilical artery Doppler from 26–28
weeks of pregnancy (Appendix 1).
Women who have three or more minor risk factors should be referred for uterine artery Doppler at 20–24
weeks of gestation (Appendix 1).