For what three reasons may a baby be born small?
Intrauterine growth restriction
The earlier in gestation a woman gives birth, the ___ ___ their baby is to survive.
earlier = less likely to survive
Which growth centile must a foetus be under to be called small for gestational age?
Which measurement can be taken on examination to track foetal growth?
What measurements can be taken on foetal ultrasound to track foetal growth?
If a baby is small for gestational age, by which point should it ideally be delivered?
Pre-term delivery is also known as ___.
Pre-term delivery is the birth of a child before which point in gestation?
What can trigger pre-term delivery?
Illness e.g infection
Over-distension e.g multiple pregnancy, polyhydramnios
Vascular disease - placental abruption
What measurements can be taken to estimate the growth of a foetus?
Estimated foetal weight
On USS: abdominal circumference, femur length
What is the definition of a low birth weight?
< 2.5kg at any point in gestation
Intrauterine growth restriction can be ___ or ___.
symmetrical or asymmetrical
symmetrical - genetic disorders
asymmetrical - placental problems
Which imaging is used to measure foetal growth during pregnancy?
Which foetal ultrasound measurements are used to estimate foetal weight?
+/- Femur length
Which specific ultrasound scans are used if poor foetal growth is suspected?
Uterine artery doppler
What underlying disease causes placental infarction and abruption?
What are some maternal reasons for intra-uterine growth restriction?
Lifestyle factors - smoking, alcohol, drug use
Co-morbidities e.g hypertension
Extremes of age
What are some foetal reasons for intra-uterine growth restriction?
Infection e.g toxoplasmosis, CMV
Genetic disorders e.g trisomy 21
What are some placental reasons for intra-uterine growth restriction?
All related to hypertension - infarction, abruption, insufficiency
What are the findings of poor foetal growth on examination?
Reduced fundal height
Reduced foetal movements
What are some types of doppler ultrasound scan used in the assessment of foetal wellbeing?
Uterine artery doppler
Umbilical artery doppler
If a baby is small for dates, when should it be delivered?
Which drugs can be used to help deliver small-for-dates babies?
Steroids - speeds up production of pulmonary surfactant
Magnesium sulphate - for neuroprotection
What is the purpose of steroids in premature delivery?
Increases lung development (production of pulmonary surfactant)
What is the purpose of magnesium sulphate in premature delivery?
If a small-for-dates pregnancy is showing signs of static growth or their scans are dodgy, what is indicated?
no matter the gestation