Problems in Pregnancy: Small for Dates Flashcards Preview

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Flashcards in Problems in Pregnancy: Small for Dates Deck (20)
1

When is a birth described as pre-term?

Delivery between 24 and 36+6 weeks.

2

How common are pre term births

6-7 percent

3

What is the survival rate of babies born at 24 weeks

20-30 percent

4

At what gestation does the survival rate of pre terms become almost 100 percent

32 weeks

(80 percent from 27weeks)

5

What are the most likely causes for a pre term birth

Infection
Over distention - multiple pregnancies, polyhydramnois
Placental abruption
Intercurrent illness- pyeloneohritis/UTI/appendicitis/pneumonia
Cervical incompetence
Idiopathic

6

What are the risk factors associated with pre term birth

Previous PTL (20 percent increase x1, 40 percent increase x2)
Multiple (50 percent risk)
Uterine anomalies
Age (teenagers)
Parity (if first or more than 5)
Ethnicity
Poor socio economic status
Smoking
Drugs (cocaine)
Low BMI (less than 20)

7

What is the definition of small for gestational age

Infant with a birthweight that is less than 10th centile for gestation (corrected for maternal height etc)

8

What maternal factors can result in IUGR

Smoking, alchohol, drugs
Height and weight
Age
Hypertension (maternal disease)

9

What fetal factors can result in poor growth

Infection eg rubella
Congenital eg absent kidneys
Chromosomal eg Down's syndrome

10

What placental factors can result in IUGR

Infarcts
Abruption
Secondary to hypertension usually

11

What is meant by symmetrical and asymmetrical IUGR

Symmetrical = small head AND small abdomen

Asymmetrical = normal head and small abdomen

12

What are the consequences of IUGR

Antenatal/labour = HYPOXIA and death

Post natal = hypoglycaemia, asphyxia, hypothermia, polycythaemia, hyperbiliribinaemia, abnormal neurodevelopment

13

What are the clinical features of poor growth

Risk factors present
Fundal height less than expected
Reduced liquor
Reduced fetal movements

14

how is fetal well being assessed

Growth
Cardiotocography
Biophysical assessment
Doppler

15

What is an accelerations?

An increase in fetal heart rate at the start of a uterine contraction returning to baseline rate before or after contraction.

Indicated good reflex reactivity of the fetal circulation

16

At what level would the baseline fetal heart rate variability be considered reduced

variability of less than 5 beats/ min

17

What can cause a loss of baseline variability

Caused by sedatives or analgesics in labour

The less variability the greater the possibility of asphyxia

18

What is a late deceleration

any deceleration whose lowest point is past the peak of contraction

19

What are decelerations associated with

asphyxia

20

At what biophysical profile would you deliver the baby

0-2

(4-6= repeat, 8-10 satisfactory)