*IUGR / SGA

Question 1

Define SGA

Answer 1

a birth weight of <10th percentile for gestational age

Average is between 10th and 90th centile
LGA >90th centile

Question 2

Define FGR

Used to be called IUGR

Answer 2

Commonly defined as a fetus less than 10th centile on growth curve.
When an infant has not reached its growth potential

Question 3

Define low birthweight, very low birthweight and extremely low birthweight

Answer 3

LBW: <2500g
VLBW: <1500g
ELBW: <1000g

Question 4

What is symmetrical growth restriction and causes?

Answer 4

All parts of the baby’s body are similarly small in size. HC in proportion to rest of body.

Insult early in pregnancy

Developed slowly throughout duration of the pregnancy

Causes: early intrauterine infections, chromosomal abnormalities, substance abuse, anaemia

Question 5

What is asymmetrical growth restriction and why does it occur?

Answer 5

The baby’s head and brain are the expected size, but the rest of the baby’s body is small. Disparity in length and head circumference.

Insult in late pregnancy

Head sparing effect. Dry, peeling skin and very thin umbilical cord

Cause: interference with placental function or maternal health in 3rd trimester, e.g. malnutrition, chronic high BP

Question 6

Risk factors for SGA/FGR

Answer 6

Environmental factors such as poor nutrition, maternal smoking, drug addiction or alcoholism
Anaemia
Prolonged pregnancy
Pre eclampsia
Chromosomal abnormalities
Diabetes Mellitus
Connective Tissue Disease/Disorders (Systemic Lupus Erythematosis), Chronic renal failure
Infections: Rubella, Cytomegalovirus, toxoplasmosis, syphilis
Multiple births

Question 7

Signs of hypoglycaemia in newborn

Answer 7

Lethargy
Pallor
Hypotonic (low muscle tone)
Hypotension
Poor feeding
Irritability
Temperature instability
Sweating
Tachycardia
Apnoea
Seizures

Can be vague and non-specific therefore prudent to check PGL,