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Flashcards in Small & Large Births Deck (22):
1

What are the 2 main causes for a small baby?

Pre-term delivery
Small for gestational age due to intrauterine growth restriction (IUGR) or simply constitutionally small!

2

How is a birth defined as preterm?

Delivery between 24-36 weeks gestation

3

List some causes of preterm birth

Infection
Overdistention (multiple pregnancy)
Placental abruption
Cervical incompetence
Idiopathic

4

How is a baby defined as being small for gestational age?

Birthweight less than 10th centile for gestation, corrected for maternal weight, height, foetal sex and birth order

5

What maternal factors cause poor growth of a foetus?

Lifestyle: smoking, drugs, alcohol
BMI 19 or less
Extremes of age
Disease: hypertension

6

What foetal factors cause poor growth of a foetus?

Infection: rubella, CMV
Congenital anomalies
Chromosomal abnormality

7

What are the consequences to the foetus if there is growth restriction?

Hypoxia
Hypoglycaemia
Asphyxia
Hypothermia
Polycythaemia
Abnormal neurodevelopment

8

What are some clinical indicators of poor growth?

Fundal height less than expected
Reduced liquor
Reduced foetal movements

9

What is cardiotocography used for?

Measure foetal heartbeat

10

What are the main aetiology behind large babies?

Wrong date
Multiple pregnancy
Diabetes
Polyhydramnios

11

What is polyhydramnios?

Excess amniotic fluid

12

What causes polyhydramnios?

Monochorionic twin pregnancy
Foetal anomaly
Diabetes
Hydrops fetalis

13

What is the difference between zygosity and chorionicity?

Zygosity: number of eggs fertilied to produce twins
Chorionicity: membrane pattern of the twins

14

Which is the outer layer - chorion or amnion?

Chorion outside
Amnion inside

15

Describe a dichorionic diamniotic pregnancy

Each foetus has its own amniotic sac and its own placenta

16

Describe a monochorionic diamniotic pregnancy

Each foetus has its own amniotic sac but shared placenta

17

Describe a monochorionic monoamniotic pregnancy

Both foetuses share amniotic sac and placenta

18

Multiple pregnancies carry higher perinatal mortality due to what?

Congenital anomalies
Preterm labour
Growth restriction
Pre-eclampsia
Twin-twin transfusion

19

How are triplets usually delivered?

Caesarean section

20

Describe the pathophysiology of gestational diabetes mellitus

Placental hormones cause insulin resistance in the mother, causing hyperglycaemia

21

How does gestational diabetes lead to macrosomia?

Overgrowth of insulin sensitive tissues due to hyperinsulinaemia

22

What are the diagnostic glucose values for gestational diabetes (fasting and 2-hour)?

Fasting: 5.1 mmol/l or more
2-hour: 8.5 mmol/l or more