SGA

Question 1

What classifies as an IUGR

Answer 1

<10th centile on the fetal growth chart

Question 2

How is IUGR classified

Answer 2

Asymmetrical vs symmetrical

Causes: Maternal, fetal, genetic or placental

Question 3

What usually causes symmetrical IUGR

Answer 3

Chromosomal abnormalities - trisomies, turners

Question 4

Examples of fetal causes of IUGR

Answer 4

Any structural abnormality

Multiple pregnancy

Question 5

Examples of maternal causes of IUGR

Answer 5

Infection - toxoplasmosis, rubella, CMV, herpes simplex
Preeclampsia
Anaemia
Substance abuse - alcohol, smoking, cocaine
Low BMI

Question 6

Examples of placental causes of IUGR

Answer 6

Placental insufficiency - low placental supply, high fetal demand, placental tumour, single umbilical artery

Question 7

Do babies with symmetrical or asymmetrical growth restriction have a better prognosis. Why?

Answer 7

Asymmetrical:
Insult occurs later in utero
Adapted to insults in utero so more likely to have a catch up growth period

Question 8

How long is the catch up growth period

Answer 8

2 years

Question 9

Immediate complications of IUGR

Answer 9

RDS
Hypoglycaemia
Hypothermia
Hypocalcaemia, hypomagnesia
Birth asphyxia
Meconium aspiration
Polycythaemia
Immunodeficiency

Question 10

Long term complications of IUGR

Answer 10

Obesity
Diabetes - MODY and type 2
Hypercholesterolaemia 
IHD
Low IQ
Developmental delay 
Poor social skills 
Poor attachment

Question 11

How can you diagnose IUGR postnatal if the mother missed fetal scans

Answer 11

Measure length and head circumference
Less buccal fat
Loose skin on neck/groin
Sharp long finger nails
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