1 / 12

Small Babies

Small Babies. IUGR and SGA. Small-for-gestational-age. A baby whose birth weight or estimated fetal weight is below a specified centile for its gestation. Usually 10 th centile (2.7kg at 40 weeks). Normal constitutionally small babies (50 – 70%) + growth restricted babies.

rianne
Download Presentation

Small Babies

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Small Babies IUGR and SGA

  2. Small-for-gestational-age • A baby whose birth weight or estimated fetal weight is below a specified centile for its gestation. • Usually 10th centile (2.7kg at 40 weeks). • Normal constitutionally small babies (50 – 70%) + growth restricted babies.

  3. Intrauterine Growth Restriction • A fetus who has failed to reach its growth potential. • May or may not be small for gestational age. • Implies a pathological process.

  4. Aetiology-Fetal factors • Genetic: Maternal ethnicity Maternal size • Chromosomal: Trisomy • Fetal anomaly • Fetal infection: CMV Rubella Toxoplasmosis Malaria Symmetrical Growth

  5. Maternal Factors • Nutrition (extreme starvation) • Drugs/Smoking • Maternal Disease: Renal disease SLE Hypertension

  6. Placental Factors • Failure of the second wave of trophoblastic invasion uteroplacental insufficiency decrease in nutrient supply Assymetrical Growth

  7. Screening & Diagnosis • Symphsio-fundal height measurement: Low sensitivity and high false-positive rates. • Ultrasound – of no value in normal low-risk women. • SGA suspected on examination – ultrasound to confirm.

  8. Management SGA confirmed on ultrasound Assess for chromosomal/structural defects Assess liquor volume and umbilical artery Dopplers Assess growth velocity

  9. Surveillance • Fortnightly ultrasound for growth • Twice-weekly Dopplers, liquor volume estimation and biophysical profile • Management of maternal conditions • CTG – no long term predictive value

  10. Deliver at the appropriate time. • When Dopplers normal – delay until 37 weeks. • Abnormal Dopplers – consider delivery depending on gestation. • Steroids and discussion with neonatologists.

  11. Implications of IUGR • Fetal abnormality • Perinatal hypoxia long-term neurological morbidity • Perinatal death • Neonatal hypoglycaemia • Necrotising enterocolitis • Adult Type II diabetes and coronary artery disease • Operative delivery

More Related