Small for gestational age

Question 1

What is small for gestational age defined as?

Answer 1

Measures below 10th centile

Question 2

What measures on US are used to assess foetal size?

Answer 2

Estimated foetal weigth
Foetal abdominal circumference - AC

Question 3

What do customised growth charts consider?

Answer 3

Ethnic group
Weight
Heigth
Parity
Of mother

Question 4

What is severe SGA

Answer 4

Below 3rd centile for GA

Question 5

What is low BW defined as

Answer 5

<2500g

Question 6

Circulating volume of a baby

Answer 6

10ml/kg

Question 7

Categories of causes of SGA

Answer 7

Constitutionally small
Foetal Growth Restriction - IUGR

Question 8

What is intrauterine growth restriction?

Answer 8

Small foetus due to pathology reducing amount of nutritents and O2 being delivered to foetus through the placenta

Question 9

Categories of causes of IUGR

Answer 9

Placenta mediated
Non placenta mediated

Question 10

Causes of placenta mediated IUGR

Answer 10

Idiopathic
Pre-eclampsia
Maternal smoking
Maternal alcohol
Anaemia
Malnutrition
Infection
Maternal health conditions

Question 11

Causes of non placenta mediated IUGR

Answer 11

Genetic abnoramlities
Strutural abnormalities
Foetal infection
Errors of metabolism

Question 12

Signs of IUGR

Answer 12

Reduced amniotic fluid volume
Abnormal dopple studies
Reduced foetal movements
Abnormal CTGs

Question 13

Complications of IUGR short term

Answer 13

Foetal death or stillbirth
Birth asphyxia
Neonatal hypoglycaemia
Neonatal hypothermia

Question 14

IUGR longterm increased risk for:

Answer 14

CVD esp HPTN
T2DM
obesity
Mood and behavioural problems

Question 15

Risk factors for SGA

Answer 15

Prev SGA baby
Obesity
Smoking
Diabetes
Existing HPTN
Pre-eclampsia
Older mother >35
Multiple pregnancy
Low pregnancy ass plasama protein - PAPPA
Antepartum haemorrhage
Antiphospholipid syndrome

Question 16

What is Preganancy ass plasma protein?

Question 17

What is monitored in low risk women?

Answer 17

Symphysis fundal height

Question 18

What is monitored in low risk women to check for SGA and when is this done?

Answer 18

Symphysis fundal height at every antenatal appointment from 24 weeks

Question 19

What happens if the symphysis fundal height is less than the 10th centile?

Answer 19

Serial growth scans with umbilical artery doppler

Question 20

When are women booked for serial growth scans with umbilical artery doppler?

Answer 20

Three or more minor risk factors
One or more major risk factors
Issues measuring symphysis fundal heigth

Question 21

What can affect ability to measuresymphysis fundal heigth

Answer 21

Large fribroids
BMI > 35

Question 22

How are women at risk or with SGA monitored in pregnancy

Answer 22

Serial ultrasound scans that measure -
Estimated foetal weigth and abdominal circumference to determine growth velocity
Umbilical arterial pulsatility index (UA-PI) to measure flow through umbilical artery
Amniotic fluid volume

Question 23

What is typical recommendation for initiation and fequency of US for SGA?

Answer 23

Every 4 weeks from 28 weeks gestation

Question 23

What is typical recommendation for initiation and fequency of US for SGA?

Answer 23

Every 4 weeks from 28 weeks gestation

Question 24

When is US frequency increased in SGA?

Answer 24

Reduced growth velocity Problems with umbilical flow

Question 25

Management of SGA

Answer 25

Identifying those at risk Aspirin if at risk pre eclampsia Treat modifiable risk factors - smoking cessation Serial growth scans to monitor growth Early delivery where growth static pr other concerns

Question 26

Investigations into underlying cause when infant determined SGA

Answer 26

BP and urine sipstick for pre-exlampsia Uterine artery doppler scannig Detailed foetal anatomy can be foetal medicine Karyotyping for chromsomal abnormalities Testing for infections

Question 27

What give womena at risk fo pre eclampsia

Answer 27

ASpririn

Question 28

What infections test for in SGA?

Answer 28

Toxoplasmosis, cytomegalovirus, syphilis and malaria

Question 29

When is early delivery considered?

Answer 29

Growth static on charts Other problems identified ef abnormal doppler results Reduces stillbirth risk

Question 30

What given before C section planned early induction

Answer 30

Corticosteroids