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A1. Women's Health > IUGR > Flashcards

Flashcards in IUGR Deck (15):
1

What is the definition of IUGR?

Intra-uterine growth restriction = failure of fetus to reach growth potential

2

How is IUGR different from Small for Dates (SFD)?

SFD = birthweight

3

Name 5 short-term consequences of IUGR

Preterm labour
Perinatal mortality (stillbirth and neonatal death)
Neonatal morbidity (hypothermia, hypoglycaemia, infection, polycythaemia, meconium aspiration, HIE)

4

Name 2 long-term consequences of IUGR

Motor and intellectual disability (CP, mental retardation)
Can extend into adult comorbid disease as well (Barker hypothesis - HT, DM, dyslipidaemia, vascular disease)

5

Name 5 foetal causes of IUGR

Congenital - chromosomal (Trisomys, Turner syndrome), single gene disorders (Russel-Silver, Fanconi), structural defects (gastroschisis, omphalocoele, diaphragmatic hernias, skeletal dysplasia, heart disease), infection (toxo, CMV)

6

Name 5 maternal causes of IUGR

Vascular disease (HT, pre-eclamp, DM, connective tissue disease)
Thrombophilia - acquired (APLS, Ca, smoking) or congenital (Protein S and C, antithrombin III, Factor V Leiden etcccc)
Toxins (smoking, EtOH, cocaine, narcotics)
Malnutrition
Cardiac disease
Anaemia
Respiratory disease

7

Name 2 placental causes of IUGR

Multiple pregnancy
Placental abruption
Placental abnormalities

8

How do you screen for IUGR in utero on examination? How accurate is this?

Symphyseal-fundal height from 20 weeks - only 66% accurate

9

What Ix can you do for IUGR? When is best to do it? What measurement is most accurate?

U/S at 34 weeks. Abdo circumference most accurate.

10

Name 2 Mx to prevent IUGR

Aspirin
Work and rest optimisation

11

Name 3 factors that would suggest a foetus is suffering from IUGR rather than just being genetically small

Parents are tall
Risk factors
Asymmetrically small
Aberrant growth trajectory
Biophysically inactive
Abnormal amniotic fluid, umbilical or Doppler studies

12

What are the 5 principles of management for a foetus with IUGR?

Confirm diagnosis
Find and treat cause (if there is one)
Fetal surveillance - CTG and U/S
Treat IUGR
Deliver

13

Should you supplement an IUGR foetus with extra nutrition (hyperalimentation)? Why/why not?

No - even if it increases size of foetus (which it might not if the IUGR has a foetal etiology), it still doesn't correct the inadequate oxygenation (from defective placental vessels or maternal circulation) = ends up dying from hypoxia

14

Name 3 therapies to best optimise IUGR before delivery

Rest
Steroids if delivery

15

When should you aim to deliver an IUGR baby? Name 1 indication to deliver earlier than this

38 weeks or later, unless signs of foetal hypoxia