IUGR: Intrauterine Growth Restriction: Causes, Diagnosis, Long term effects: Brocato Flashcards Preview

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Flashcards in IUGR: Intrauterine Growth Restriction: Causes, Diagnosis, Long term effects: Brocato Deck (25):
1

What is the definition of IUGR?

Less than 10th percentile than estimated normal

2

TEST? What is the etiology of IUGR?

Extrinsic and Intrinsic causes: see below

3

TEST? What is the diagnosis of IUGR?

Ultrasound
Fundal height for screening
Risk factors

4

What is the management/timing of delivery in IUGR?

x

5

TEST? What are the immediate and long term sequelae of IUGR?

x

6

What goes up as fetal size goes down?

Morbidity
Mortality

7

What are extrinsic (maternal) risk for IUGR?

HTN
Renal dz
COPD
Diabetes
Collagen dz
Hemoglobinopathies
Smoking
Malnutrition
Infections

8

What are the intrinsic risk factors of IUGR?

Aneuploidy
Genetic syndromes
Congenital anomalies
Placental disease
Multiple gestation

9

What is the highest contributor to IUGR?

Maternal vascular disease
diabetes
lupus
htn
etc...

10

What happens in maternal vascular disease?

Decrease IU perfusion
HTN/PREClampsia

11

What are the infections causing IUGR?

TORCHES

12

What is oligohydramnios?

Low amniotic fluid: <5 cm

13

What happens in oligohydramnios to cause IUGR?

Chronic hypoxia diverts blood from kidneys to vital organs, less fluid made

increased risk of mortality

normal fluid less likely to end in demise

14

What do doppler indices reflect?

Umbilical artery
Middle cerebral artery
Venous circulation
Uterine arteris

15

What direction does blood move in umbilical artery? vein?

Artery: blood going from baby to placenta (no O2)
Vein: Blood going to baby from placenta (high O2)

16

What does doppler ultrasound help us determine?

How hard it is to get blood into and out of placenta (vascular resistance)

17

When are uterine artery flow measured?

Preecclampsia
CHTN

18

What arteries are measured on doppler?

Umbilical artery
Middle cerebral artery

19

What veins are measured in doppler?

Umbilical vein
Ductus venosus (shunt away from lungs to aorta from pulmonic artery)

20

What is typical of HTN dopplar?

Retrograde flow in veins and arteries: FLOW SHOULD ONLY GO FORWARD!!!! Systole and diastole too.

21

What is the most important nutrient for fetus?

Oxygen

22

If you are not oxygenated, what happens?

Acidosis: organ failure

23

How do you determine a IUGR delivery?

Case to case basis

24

What does IUGR baby become after birth?

SGH: "small for gestational age"

25

Big baby buzzword?

Gestational diabetes
Diabetes in general