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Flashcards in Small for dates Deck (21):
1

what are the reasons a baby can be small

pre term delivery
small for gestational age - just small or IUGR

2

definition of pre term birth
survival rates at 24, 27 and 32 weeks

between 24 and 36 weeks

24 - 50%
27-80%
32->95%

3

pre term birth causes

infection
over distention
vascular
intercurrent illness
cervical insufficiency
PPROM
idiopathic

4

give some causes of over distention

multiple preg
polyhydramnios
fibroids

5

give some causes of vascular

placental abruption - small bit of the placenta separates and bleeds

6

give some causes of intercurrent illness

polynephritis/UTI
appendicitis
pneumonia

7

what does cervical insuffieciency mean

starts to open and dilate at early point

8

what does PPROM mean

preterm premature rupture of the membrane

9

what are some of the risk factors associated with pre term birth

previous pre term labour
multiple preg (50% risk)
uterine anomalies
age - teens
parity =0 or >5
ethnicity
poor socio economic status
smoking
drugs - esp cocaine
low BMI <20

10

how many pre term births are planned C sections?
what are other causes

25% - severe eclampsia, kidney disease or poor fatal development
20% premature rupture of membranes -> vaginally
25% emergency event - placental abruption, infection, eclampsia
rest unknown

11

what are the two causes for a baby being small and what is the cut off

<10th centile
small for gestational age
intra uterine growth restriction

12

what are the three main causes for IUGR

maternal
fetal
placental

13

maternal factors for IUGR

smoking, alcohol, drugs
height and weight
age - extremities
hypertension, pre eclampsia

14

fetal factors for IUGR

infection - rubella, CMV, toxoplasma
congenital disease sth as absent kidneys
chromosomal abnormalities such as downs syndrome

15

placental factors for IUGR

infarcts
abruption
often secondary to hypertension of pe eclampsia

16

classification of IUGR

symmetrical - head and abdomen proportionally small
assymetrical - one is bigger - usually placental failure

17

what are the consequences for the baby for being growth restricted

risk of hypoxia/death

post natal - hypoglycaemia, effects of asphyxia, hypothermia, polycythaemia, hyperbilirubinaemia, abnormal development

18

clinical features of poor growth

pre disposing factors
fundal height less that expected
reduced liquor - deficiency of amniotic fluid
reduced fetal movements

19

assessing fetal wellbeing

assessment of growth
cardiotocogrophy
biophysical examination
doppler US

20

what is a biophysical examination

movement
tone
fatal breathing movements
liquor volume

score out of 10

8-10 fine
4-6 repeat
0-2 deliver

21

if the baby is delivered too early what can happen
if its delivered too late what can happen

iatrogenic prematurity
prenatal asphyxia/IUFD