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Jason's MD3 Women's > IUGR > Flashcards

Flashcards in IUGR Deck (32):
1

Causes of baby being small? Placental?

Multiple preg
Abrupt ion
Placental abnormalities?

2

4 congenital disease

Chromosomal
Genetic
Structural
Familial?

3

UPD uni parental disomy dangerous why?

Because will get all autosomal recessive disorders

4

Maternal restraint of growth?

Prevent too big a baby in uterus

5

If have UPD both from mom? Dad?

Double growth genes from mother = big baby

Dad: both growth genes off = small Abby

6

How to get UPD?

trisomy and loses drops one

7

Confined placental mosaicism?

Placenta has trisomy, fetus doesn't

8

important Structural defect

Gastroschisis

9

two infections that cause IUGR?

CMV
Toxoplasma

10

Where to get CMV?

Day care

11

What kind of CMV virus is virus?

Herpes Virus

12

How to prevent CMV?

Hand-washing!!!
Hand-washing!!!

13

Where do you get toxo?

Stray cats - pooing in garden and your gardening/sandbox.

HAND WASHING!

14

Toxoplasmosis is What species?

Parasite

15

Vascular diseases?

Hypertension
DM - atherosclerosis
Renal disease
SLE
Vasculitis

16

Thrombophilia

Congenital
Acquired: anti phospholipid
-preg
-smoking
-Rest, sx, cancer

17

6 hereditary thrombophilias?

Hyperhomocystenaemia
Factor V
Prothrombin
Protein S, C
Anti-thrombin II

18

Toxins?

Smoking
Alcohol
Malnutrition
Anaemia
High altitude (lower O2)

19

Common reason for placenta abrupt ion?

Hemorrhagic infarct (99%)
Trauma(1%)

20

Screening for IUGR

Symphysis-fundal height
~34 weeks

21

Optimal single biometric measure?

Abdominal circumference

22

Preventing IUGR?

-Aspirin
-Work and rest optimization
-NOT vitamin E or C

23

Mx of IUGR?

Confirm Dx
Look for cause
Surveillance
Therapy
Delivery

24

How to confirm genetically small?

Small parents
Absence of risk factors
Symmetrical small
Normal growth trajectory
Bio physically active
Normal amniotic fluid
Normal umbilical and other Dopller studies

25

How to investigate IUGR

Tertiary ultrasound
***ANTI-phospholipid syndrome***

26

Karyotyping NIPS, why do it at 35weeks?

-Won't compromise future reproduction, prevent unnecessary C-section if baby was destined to die anyways.

-psychological
-prepare the paediatricians
-termination in late preg

27

Can you terminate pregnancy?

Inject KCl
Need 2 doctors, not reason

28

Viability of baby after how many weeks?

24-weeks

29

Why terminate late?

-If prognosis is not known until late preg (eg. CMV)
-twins discordant

30

Rx of IUGR?

Can't use aspirin - too late

Nutrition
Control DM better
Treat toxo
TPN will work - hyperalimentation but will die: grow too big for placenta (O2)

31

Hyperalimentation works?

Yes, will grow, but will outgrow O2 placenta supply and die. Not use.

32

If lung immaturity and need neuro protection if less than 30 weeks.

MgS04
Steroids