Created by Liam Musselbrook
almost 8 years ago
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Question | Answer |
Principal associations of cerebral palsy | Preterm IUGR Congenital abnormalities Intrapartum fetal distress Pre-eclampsia Infection |
Define small for dates (SFD)/small for gestation (SFG) | The weight of the fetus is less than the tenth centile for its gestation |
Identification of the high-risk pregnancy: prepregnancy | Poor past obstetric history or very small baby Maternal disease Assisted conception Extremes of reproductive age Heavy smoking or drug abuse |
Identification of the high-risk pregnancy: during pregnancy | Hypertension/ proteinuria Vaginal bleeding Small for dates (SFD) baby Prolonged pregnancy Multiple pregnancy |
Identification of the high-risk pregnancy: investigations | Cervical scan at 23 weeks Uterine artery Doppler Maternal blood tests, e.g. PAPP-A |
Methods of surveillance in the high-risk pregnancy | Fortnightly (max.) US - growth Umbilical artery Doppler - identify compromised fetus CTG on a daily basis Methods specific to disorder, e.g. blood pressure in pre-eclampsia |
In what three ways can ultrasound scans be used to monitor whether fetal growth is healthy? | 1. Comparison to previous scans 2. Compare growth of abdomen to that of the head (abdo growth will slow before head growth if compromised) 3. Compare actual growth against expected growth for individual fetus |
Cardiotocography (CTG) | Fetal heart is recorded electronically Accelerations and variability >5 bpm should be present Decelerations should be absent Rate should be 110–160 bpm |
Constitutional determinants of smaller fetal size and growth | Low maternal height and weight Nulliparity Asian ethnic group Female fetal gender |
Pathological determinants of fetal growth causing IUGR | Pre-existing maternal disease Pre-eclampsia Multiple pregnancy Smoking Drug usage Infection e.g. CMV Extreme malnutrition Congenital abnormalities |
What are the risks of prolonged pregnancy? | More common: stillbirth, neonatal illness, encephalopathy, meconium passage, fetal distress |
Management of prolonged pregnancy | From 41 weeks: Examine the patient vaginally and induce unless cervix very unfavourable (not ripe), or patient prefers to wait If no induction: sweep cervix and arrange daily CTG |
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