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42 Cards in this Set

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Is the human fetal growth pattern linear?
No, it's sigmoida, and it increases in a curvilinear fashion w/ gestational age.
What is the rate of fetal growth during weeks 14-15?
5 g/day
What is the rate of fetal growth at 20 weeks?
10 g/day
What is the rate of fetal growth at 32-24 weeks?
30-35 g/day
How much more than female babies do male babies weigh?
150-100 grams
What happens to fetal growth if there is a chromosomal disorder?
Growth is poor.
What is the primary fuel for the fetus?
Glucose
What hormones are major players in fetal growth?
Insulin and Insulin-like growth factor
When does fetal swallowing begin?
When urine enters amniotic space (8-11 weeks)
How do hormonal contraceptives affect the timing of ovulation?
They make it less predictable.
What's Naegele's rule?
It it used to date pregnancy. Add seven days to first day of LMP, then count back three months. It predicts delivery date w/in 23 days.
What is fundal height and how is it used in pregnancy dating?
It is the distance b/w pubic symphysis and top of uterine fundus; predicts the gestational age (w/in 2 cm) at > 20 weeks. It is less accurate than certain LMP, but more accurate than uncertain LMP.
What is quickening and when does it happen?
Quickening is the first motion of the fetus felt by the mother. It happens at 19 weeks (nulliparous) and 17.4 weeks (multiparous)
When can we hear fetal heart sounds?
Fetoscope = 17 wks
Doppler = 10 wks
How do combined clinical parameters compare to menstrual history in the dating of pregnancy?
Two clinical parameters or >3 fundal height measurements are almost as accurate as sure LMP.
What is crown-rump length?
It is a measurement made during the first trimester using ultrasound to date pregnancy. It is accurate to w/in 7 days & the most accurate biometric parameter.
What is biparietal diameter?
It is a measurement made during the 2nd trimester using ultrasound to date pregnancy. It's taken at the level of the thalami & cavum septum pellucidum.
What is abdominal circumference?
It is a measurement made during the 2nd trimester using ultrasound to date pregnancy. It's taken at the level of the stomach and umbilical vein at it's entrace to the liver. The most susceptible to variation.
What is meant by "appropriate-for gestational-age (AGA)?"
Fetal weight b/w 10th and 90th percentiles.
What is meant by "small-for-gestational-age (SGA)?"
Fetal weight less than 10th percentile.
What is meant by "large-for-gestational-age (LGA)?"
Weight greater than 90th percentile.
What does "FGR" or "IUGR" mean?
Fetal Growth Restriction/Itrauterine Growth Restriction. Birth weight is below 10th percentile or infant that does not grow to its full potential.
What are the complications of FGR?
It is the 2nd most important cause of perinatal mortality.
What are some genetic etiologies of FGR?
Congenital malformations:
1. CV anomalies
2. Abdominal wall defects
3. Skeletal dysplasias
4. Renal agenesis.
What are fetal etiologies of FGR?
1. Genetic factors
2. Congenital infection
3. Multiple gestation
What is the mechanism of congenital infection in causing FGR?
There are a decreased number of cells during organogenesis; it's "symmetric"
What are some placental factors assoc w/ FGR?
1. Circumvallate placenta
2. Placental infarction
3. Placental abruption
4. Prolonged pregnancy
5. Placenta previa
What are some maternal etiologies of FGR?
1. Malnutrition
2. Reduced oxygenation
3. Maternal vascular dz
Reduced maternal nutrion during which trimester has the most dramatic effect on birth weight?
The 3rd trimester.
What is responsible for the majority of clinical FGR?
Maternal vascular dz.
What are some environmental factors assoc w/ FGR?
1. Cigarette smoking
2. Alcohol
3. Cocaine
What is the strongest risk factor for FGR?
Prior birth of an FGR infant (25%).
If the FGR is symmetric, what does that indicate?
1. Occurred early in gestation
2. Decrease in overall cell number
3. All growth parameters are equally affected.
If the FGR is asymmetric, what does that indicate?
1. Occurred late in gestation
2. Decrease in cell size
3. Abdominal circumference decreased, head and long bones spared.
How do we diagnose FGR?
Serial Ultrasound: est fetal weight < 10th percentile best predictor. Adominal Circumference best single parameter.
How should serial fundal height measurements be used in detecting FGR?
It should be used as screening technique only b/c it has poor sensitivity in detecting FGR.
How should we follow-up FGR?
Serial ultrasound every 3 wks.
When should we deliver an FGR baby preterm?
When fetal testing is abnormal.
What does macrosomia mean?
Birth weight is > 4000 grams.
What are some fetal etiologies of LGA?
1. Beckwith-Wiedemann Syndrome
2. Insulin-Secreting Tumors
What are some maternal etiologies of LGA?
1. Diabetes
2. Previous large infant
3. Multiparity
4. Obesity
5. Excessive weight gain
What gestational length is assoc w/ LGA?
Post-term gestation (>42 weeks)