abnormal growth in pregnancy

Question 1

what is SGA

Answer 1

birth weight <10th decile

Question 2

how is SGA diagnosed

Answer 2

abdominal circumference (AC) or USS to estimated foetal weight

Question 3

what is a low birth weight

Answer 3

any baby born under 2.5kg

Question 4

what is Fetal growth restriction

Answer 4

abdo circumference or estimated foetal weight below 3rd decile (or below 10th + placental dysfunction)

Question 5

RF SGA

Answer 5

placental dysfunction // maternal infection // congenital or chromosomal abnormality // smoking, alcohol, drugs

Question 6

consequences of prematurity

Answer 6

Resp distress // intraventricular haemorrhage // nec enterocolitis // lung disease, hypothermia, feeding problems, infection, jaundice // retinopathy // hearing problems

Question 7

when does retinopathy occur in prematurity

Answer 7

before 32 weeks

Question 8

what is macrosomnia

Answer 8

baby over >90th decile // over 4.5kg

Question 9

what is polyhydramnios

Answer 9

excess amniotic fluid

Question 10

causes polyhydramnios

Answer 10

maternal diabetes!! // foetal anomaly // twins // virus // hydrops fetalis

Question 11

signs polyhydramnios

Answer 11

tense, shiny bump // cant feel fetal parts // large for dates

Question 12

invx polyhydramnios

Answer 12

USS

Question 13

what is oligohydramnios

Answer 13

reduced amniotic fluid (<500ml at 32-36 weeks)

Question 14

causes oligohydramnios

Answer 14

PROM // potter sequence (renal agenesis) // IUGR // post term // pre-eclampsia

Question 15

RF twins

Answer 15

FH // increased maternal age // multigravida // IVF // afro-carribean

Question 16

what is Zygosity and Chorionicity

Answer 16

zygosity = no of eggs (eg monozygous from 1 egg, dizycgous from 2) // chorionicity = number of placentas

Question 17

what type of chorionicity do dizygotic twins have

Answer 17

dichorionic (2 placenta) and diamniotic (2 sacs)

Question 18

what type of chorionicty can monozygotic twins have

Answer 18

DCDA, MCDA, MCMA, conjoined

Question 19

what determines a monozygotic twins chorionicty

Answer 19

date of cleavage

Question 20

most common chorionicty for monzygotic twin

Answer 20

MCDA (1 placenta, 2 sacs)

Question 21

symptoms twins

Answer 21

exaggerated pregnancy // large for dates // multiple fetal poles

Question 22

complications twins

Answer 22

polyhydramnios // hypertension // aneamia // APH, PPH // cord entanglement // premature // fetal death // growth restriction // twin to twin transfusion

Question 23

complication and invx from single fetal death

Answer 23

risk nuero abnormality to other twin // MRI at 4 weeks

Question 24

what is twin to twin tranfusion syndrome

Answer 24

donor perfuses recipient twin

Question 25

consequences twin to twin tranfusion syndrome donor

Answer 25

restricted growth, anaemia, decreased blood volume, oligohydramnios

Question 26

consequences twin to twin transfusion syndrome recipient

Answer 26

polyhydramnios and HF

Question 27

mx twin to twin tranfusion

Answer 27

<26 weeks = laser ablation // >26 weeks = amnioreduction // >34 weeks = delivery

Question 28

delivery twins

Answer 28

most by 38 weeks, induce by 38-40

Question 29

supplements for twins

Answer 29

iron and folate

Question 30

types of foetal lie

Answer 30

longitudinal, transverse, oblique

Question 31

when do most transverse lie move to longitudinal

Answer 31

32 weeks

Question 32

RF transverse lie

Answer 32

previous pregnancy // fibroids // twins // premature // polyhydramnios

Question 33

complications transverse lie

Answer 33

PROM // cord prolapse // compound presentation

Question 34

mx transverse lie

Answer 34

external cephalic version // elective c section

Question 35

what is post-term pregnancy

Answer 35

extended beyond 42 weeks

Question 36

neonatal complication post-term pregnancy

Answer 36

reduced perfusion // oligohydramnios

Question 37

maternal complications post-term pregnancy

Answer 37

increased chance of forceps or c section // labour indcution