Brainscape's Knowledge GenomeTM

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


See full index

Practice bulletins > #204 Fetal Growth Restriction > Flashcards

#204 Fetal Growth Restriction Flashcards

1
Q

What is the definition of fetal growth restriction per ACOG?

A

Estimated fetal weight less than the 10th percentile for gestational age

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

What is the definition of small for gestational age according to ACOG?

A

Newborns whose birth weight is less than the 10th percentile for gestational age

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

What maternal medical conditions can lead to fetal growth restriction?

A

Pregestational diabetes mellitus, renal insufficiency, autoimmune disease (eg, SLE), cyanotic cardiac disease, pregnancy-related HTN diseases of pregnancy (eg, CHTN, GTN, PEC), antiphospholipid antibody syndrome, substance use and abuse (eg, tobacco, alcohol, cocaine, narcotics)

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

Does malaria affect fetal weight?

A

Yes, risk of growth restriction

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

Does cytomegalovirus affect fetal weight?

A

Yes, risk of growth restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Does rubella affect fetal weight?

A

Yes, risk of growth restriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Does toxoplasmosis affect fetal weight?

A

Yes, risk of growth restriction

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

Does syphilis affect fetal weight?

A

Yes, risk of growth restriction

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

Is factor V Leiden mutation associated with fetal growth restriction?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Is Prothrombin mutation associated with fetal growth restriction?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Is methylenetetrahydrofolate reductase gene mutation associated with fetal growth restriction?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does tobacco use affect the risk (fold increase/decrease) of small for gestational age?

A

3.5-fold increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Does additional nutrient intake in the absence of true maternal malnutrition increase weight and/or improve outcomes in cases of suspected fetal growth restriction?

A

No high-quality evidence to suggest it does

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Twin pregnancies account for what % of live births in the US?

A

2-3%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Twin pregnancies account for what % of adverse neonatal outcomes in US?

A

10-15% [only 2-3% of live births]

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the risk of SGA in twin pregnancies?

A

As high as 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the risk of SGA with triplet and quadruplet pregnancies?

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some classic medications that are associated with fetal growth restriction?

A

Certain antineoplastic medications (eg, cyclophosphamide), antiepileptic drugs (eg, valproic acid), and antithrombotic drugs (eg, warfarin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What cases of fetal growth restriction are suspected to be caused by infection?

A

5-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What infection accounts for the most cases of infection-related growth restriction worldwide?

A

Malaria

21
Q

Does varicella infection affect fetal weight?

A

Yes, risk of growth restriction

22
Q

What % of fetuses with trisomy 13 or 18 have fetal growth restriction?

A

At least 50%

23
Q

How often do fetuses with gastroschisis have fetal growth restriction?

A

Up to 25% of cases

24
Q

Is fetal growth restriction associated with placenta accreta and/or placenta previa?

A

No

25
Q

What placental disorders are associated with fetal growth restriction?

A

Abruption, infarction, circumvallate shape, hemangioma, and chorioangioma

26
Q

What umbilical cord abnormalities are associated with fetal growth restriction?

A

Velamentous or marginal cord insertion. Some studies say single umbilical artery is associated with FGR, others do not.

27
Q

What % of pregnancies have a single umbilical artery?

A

1%

28
Q

Is fetal growth restriction associated with longterm outcomes? If so, what?

A

Predisposed to development of cognitive delay in childhood and diseases in adulthood (eg, obesity, T2DM, CAD, and stroke)

29
Q

What is the risk of fetal death (%) in fetuses weighing <10%tile? How does it compare to background rate?

A

1.5% (twice the background rate of fetuses of normal growth)

30
Q

What is the risk of fetal death (%) in fetuses weighing <5%tile?

A

2.5%

31
Q

What complications are small-for-gestational-age newborns predisposed to?

A

Hypoglycemia, hyperbilirubinemia, hypothermia, intraventricular hemorrhage, necrotizing enterocolitis, seizures, respiratory distress syndrome, and neonatal death

32
Q

What is the sensitivity and specificity of fundal height measurements at 32-34wks gestation for detecting fetal growth restriction?

A

65-85% sensitive; 96% specific

33
Q

What is the % error of ultrasound EFW in 95% of cases?

A

Up to 20% deviation

34
Q

How does umbilical artery Doppler velocimetry added to standard antepartum testing in the setting of fetal growth restriction affect outcomes?

A

Reduces the rate of perinatal death by as much as 29%

35
Q

How does monitoring flow of ductus venosus affect outcomes in growth restricted fetuses?

A

Use has not been shown to improve outcomes

36
Q

When should you start performing fundal height measurements at prenatal visits?

A

After 24 weeks

37
Q

With what fundal height to gestational age discrepancy should you investigate further?

A

Greater than 3

38
Q

What is the risk of recurrence of a small for gestational age birth?

A

Approximately 20%

39
Q

What nutritional and dietary supplemental strategies are recommended for the prevention of fetal growth restriction?

A

None, they are not effective and not recommended

40
Q

Does bed rest help prevent fetal growth restriction or reduce the incidence of SGA births?

A

No

41
Q

Does timing of onset of fetal growth restriction help assess if it is genetically related?

A

Yes, fetal growth restriction is more commonly detected earlier if associated with aneuploidy, midtrimester onset is an indication to offer genetic counseling and prenatal diagnostic testing

42
Q

If fetal growth restriction a reason to offer genetic testing?

A

Suspicious for genetic abnormalities if:

  • early onset
  • associated with structural abnormalities on ultrasound
43
Q

How often should you assess EFW in fetus with growth restriction?

A

Typically every 3-4 weeks, earliest would be every 2 weeks

44
Q

Should flow in ductus arteriosis guide timing of delivery in growth restricted fetuses?

A

Uncertain. TRUFFLE study showed less neurodevelopmental deficiency at 2yrs if delivered based on DV doppler, but associated with increase in perinatal and infant mortality.

45
Q

When should you deliver a baby with isolated fetal growth restriction?

A

38w0d to 39w6d

46
Q

When should you delivery a baby with fetal growth restriction with additional risk factors for adverse oucomes (eg, oligohydramnios, abnormal umbilical artery doppler, maternal risk factors, or comorbidities)?

A

32w0d to 37w6d. Earlier delivery in this range may be indicated for most severe cases (eg UA reversed end diastolic flow)

47
Q

Which fetuses with growth restriction are candidates for antenatal corticosteroids?

A

If delivery is anticipated before 33w6d or if between 34w0d and 36w6d at risk for preterm delivery within 7d and did not receive previous course of antenatal corticosteroids

48
Q

Which patients with fetal growth restriction should receive magnesium for neuroprotection?

A

Those delivery before 32 wks

49
Q

Is fetal growth restriction an indication for cesarean delivery?

A

No

Practice bulletins (83 decks)

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