Growth monitoring, stillbirth Flashcards Preview

Stage 3: EJR - Obstetrics > Growth monitoring, stillbirth > Flashcards

Flashcards in Growth monitoring, stillbirth Deck (15):

Foetal indications for growth scans (current pregnancy)

• First fundal height measurements at 26-28w below 10th centile
• Static/ slow/ excessive growth
• Suspected polyhydramnios/ oligohydramnios
• Suspected/ confirmed foetal anomaly
• Multiple pregnancy


Maternal indications for growth scans (current pregnancy)

• Maternal smoking (including smoking while trying to get pregnant)
• Late booker (20+ weeks gestation)
• Substance misuse


Past obstetric history indications for growth scans

• Previous unexplained stillbirth
• Previous birthweight <10th centile


Past gynae history indications for growth scans

• Pre-existing diabetes
• Chronic illness
• Uterine fibroids 6+ cm
• BMI >35


What 3 measurements are made in a foetal growth scan

1. head circumference
2. abdominal circumference
3. femur length


Components of customised growth chart

• Mum’s ethnicity
• Mum’s weight & height
• Parity
• Note: does NOT include gender


Definition of Small for Gestational Age

Weight of foetus <10th centile for its gestation


Definition of IUGR

Foetus failed to reach growth potential (based on customised growth chart)


Non-pathological causes of a small baby

• Low maternal height & weight
• Asian ethnicity
• Nulliparous
• Female foetus


Pathological causes of IUGR

• Maternal renal, autoimmune disease, pre-eclampsia
• Multiple pregnancy
• Smoking, drug usage
• Infection eg CMV
• Extreme exercise, malnutrition
• Congenital abnormalities


Which type of scan is best for assessing placental dysfunction after 34 weeks

Foetal MCA Doppler


How often are growth scans in SGA baby

2-3 weekly intervals


How often are growth scans in IUGR baby

Review at least 2x a week.
Daily CTG if <32 weeks

If absent end diastolic flow seen, admit mum to hospital. give steroids.


Definition of stillbirth

Foetus delivered after 24weeks with no signs of life


Risk factors for stillbirth

• IUGR, particularly due to smoking, multiple pregnancy
• Congenital abnormalities
• Diabetes, autoimmune disease, sickle cell disease, renal disease
• GDM, pre-eclampsia leading to placental insufficiency
• Infection
• Placental abruption