Gestational Weight Abnormalities Flashcards

(30 cards)

1
Q

What is small for gestational age?

A

A fetus that measures below the 10th centile for their gestational age

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2
Q

What is severe small for gestation age?

A

A fetus below the 3rd centile for their gestational age

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3
Q

What are the two causes for a small gestational age?

A

Constitutionally Small

Fetal Growth Restriction

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4
Q

How do we identify if the cause for a small gestational age is constitutional?

A

They are identified by small size at all stages but growth following the centiles

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5
Q

What does a constitutional cause for a small gestational age mean?

A

There is no pathology present - runs in the familiy

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6
Q

What does a fetal growth restriction cause for a small gestational age mean?

A

There is a small fetus due to a pathology reducing the amount of nutrients and oxygen being delivered to the fetus through the placenta

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7
Q

What are the two categories of fetal growth restriction causes for a small gestational age?

A

Placenta Mediated Growth Restriction

Non-Placenta Mediated Growth Restriction

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8
Q

What is placenta mediated growth restriction?

A

It refers to conditions that affect the transfer of nutrients across the placenta

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9
Q

What are the five placenta mediated growth restriction causes?

A

Maternal Alcohol

Maternal Smoking

Anaemia

Malnutrition

Diabetes

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10
Q

What is non-placenta mediated growth restriction?

A

It refers to pathology of the fetus

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11
Q

What are the three non-placenta mediated growth restriction causes?

A

Structural Abnormalities

Genetic Abnormalities

Fetal Infections

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12
Q

What are the five investigations used to diagnose small for gestational age?

A

Ultrasound Scan

Uterine Artery Doppler

Amniotic Fluid Volume

Cardiotocography

Karyotyping

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13
Q

What two measurements are obtained from an ultrasound scan to diagnose small for gestational age?

A

Estimated fetal weight (EFW)

Fetal abdominal circumference (AC)

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14
Q

What chart is plotted after an ultrasound scan to diagnose small for gestational age?

A

Customised growth charts

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15
Q

What are customised growth charts?

A

Charts to assess the size of the fetus based on the mother’s height, weight, ethnicity and parity

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16
Q

How do we conservatively manage patients with a small gestational age?

A

It involves treating modifiable risk factors, such as smoking cessation and optimising maternal disease

It also involves close monitoring using a uterine artery doppler

17
Q

When do we consider early delivery of small gestational age babies?

A

When growth is static on the growth charts or other problems are identified

18
Q

What delivery method is used in small gestational age babies before 37 weeks gestation?

19
Q

What delivery method is used in small gestational age babies after 37 weeks gestation?

A

We offer labour induction with vaginal delivery

20
Q

What do we prescribe patients when delivery is considered between 24 and 36 weeks’ gestation (small for gestational age)? Why?

A

A single course of antenatal steroids should be given

This is to promote fetal lung growth, reducing the risk of respiratory distress syndrome

21
Q

What are the four short-term complications of small gestational babies?

A

Stillbirth

Neonatal Hypothermia

Neonatal Hypoglycaemia

Birth Asphyxia

22
Q

What are the four long-term complications of small gestational babies?

A

Type Two Diabetes

Obesity

Hypertension

Cancer

23
Q

What is large for gestational age (macrosomia)?

A

It is defined when the weight of the newborn is more than 4.5kg at birth

During pregnancy, an estimated fetal weight above the 90th centile is large

24
Q

What are the four causes of large gestational age?

A

Constitutionally Large

Maternal Diabetes

Overdue Baby

Maternal Obesity

25
What two investigations are used to diagnose large gestational age?
Ultrasound Scan (same as small gestational age) Oral Glucose Tolerance Test
26
What is an oral glucose tolerance test used to diagnose large for gestational age?
To identify a potential underlying cause for macrosomia – gestational diabetes
27
How do we deliver large gestational age babies?
Normal vaginal delivery
28
What is the main complication of delivery of large gestational babies? How do we reduce this risk?
Shoulder dystocia Delivery is conducted on a consultant lead unit and the third stage of labour is managed actively
29
What are the four maternal complications of large gestational age?
Shoulder Dystocia Failure to Progress Perineal Tears Postpartum Haemorrhage
30
What are the four fetal complications of large gestational age?
Birth Injury Neonatal Hypoglycaemia Obesity Type Two Diabetes