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22 Cards in this Set
- Front
- Back
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To qualify for IUGR, a fetus has to be below this weight criteria:
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Less than 10% of normal population for a specified gestational age
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(T/F) The IUGR fetus should be viewed as fragile, and the smaller the fetus the greater the risk for morbidity and mortality.
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True
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Why will early onset IUGR lead to symmetrical growth restriction?
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Because at the beginning most of the fetal growth is by cellular hyperplasia or division
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What percentage of IUGR is idiopathic?
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50%
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On average, how much smaller are babies from mothers who smoke compared to their non-smoking counterparts at term?
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1/2 pound smaller
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As a general rule maternal weight gain during pregnancy does not correspond to IUGR except in these two circumstances:
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Teen mothers
Severe nutrition deficiency |
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Recommended weight gain during pregnancy for a woman with a normal habbitus?
Would the recommendations for weight gain be more or less for an obese patient? |
Approximately 25 to 35 pounds
Less if the patient is already obese |
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What is the most common known maternal factor associated with IUGR?
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Hypertensive disease
Accounts for 25% of all cases. |
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Two infections that are usually associated with IUGR?
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Rubella and CMV
Usually occurs in early pregnancy |
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Why is the combination of oligohydramnios and IUGR worrisome?
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It means there is more severe disease
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Pathophysiology of IUGR + Oligohydramnios?
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Decreased placental perfusion of O2 and nutrients causes redistribution of blood away from the kidneys to the brain and andrenals and heart.
Without full perfusion of the kidneys there is low amounts of amniotic fluid |
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Which of these cannot be assessed by amniotic fluid analysis?
PCR Viral cultures Fetal karyotyping Evaluation of free floating fibroblasts |
Evaluation of free floating fibroblasts
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Three ways to karyotype during pregnancy:
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Amniocenesis
Chorionic villus sampling (or biopsy of placenta) Direct fetal blood testing |
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Is biparietal diameter (BPD) ultrasound better for asymmetric or symmetric IUGR?
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Better for asymptommatic
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What is measured by doppler velocimetric examination?
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Measures blood flow through an artery - usually umbilical.
You measure the systolic / diastolic (S/D) ratio which is an indirect measure of resistance downstream. A downstreatm impedences decreases D so S/D increases. |
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IUGR seems to be at even greater risk if this ductus is abnormal:
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Ductus venosis
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These two arteries are usually evaluated by doppler?
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umbilical artery and fetal middle cerebral artery
-Usually looked at earlier in the pregnancy, compared to Ductus venosus and umbilical vein |
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When would you use amnionfusion (installation of warmed normal saline via transcervical catheter)?
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If fetal heart rate decelearations are thought to be caused by oligohydramnios
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What is hyperviscosity syndrome?
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When the fetus tries to complensate for poor placental oxygen transfer by increasing hematocrit to over 65%
Leads to polycythemia, thrombosis, heart failure, and hyperbilirubinemia |
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When to suspect macrosomnia based on physical exam of a pregnant lady?
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If fundal height is greater than 4 cm than expected for getational age.
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Differential diagnosis for excessive fundal height (above what would expected for a given gestational age):
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Macrosomnia
Multiple gestations Uterine fibroids Polyhydramnios Molar pregnancy Constitutionally large baby |
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The American college of OB/GYN recommends c-section for babies greater than these weights:
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Greater than 5000g in a woman without diabetes, or greater than 4500g in a woman with diabetes
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