SlideShare uma empresa Scribd logo
1 de 19
Baixar para ler offline
DISCREPANCY IN
          UTERINE SIZE
An understanding of the issues involved when a
uterus doesn’t correspond to its gestational age
By

Associate Professor Dr
      Hanifullah Khan
Objectives




 To understand the       To understand the       The important points to
  definitions involved     implications of this
                                situation           consider
Discrepancy – what is
it?
When the uterine size does not
correspond to the expected
gestation
May be larger or smaller
Objective measurement - > 2 cm
variation with symphysiofundal
height (SFH)
Is there an
                                       Is there a
                 underlying
                                     problem with
              problem causing
                                     the mother?
              this discrepancy?


                                                Is the fetus at
Has there been a
                                                risk?
  mistake in
  calculating                                   • If so, when do we
                                                  deliver it?
  gestation?               Implications
                               of this
                             situation
Points to consider
 The patient has been found to
  have a gestation which does
  not correspond to
  calculations.
 This may be a feature of an
  underlying problem
 The problem may be related
  to the mother, fetus or
  placenta
 It is our job to determine the
  underlying cause of this
  problem
In all cases, always begin by
Dates                                                confirming the dates




Be absolutely positive
   The mother remembers the exact LMP
   (1st day)
   The periods have been regular
   The onset of pregnancy symptoms &
   quickening correspond to the dates
   That an early pregnancy ultrasound (if
   done), confirmed the dates
   Subsequent antenatal check ups have
   noted previous corresponding growth of
Remember, an early pregnancy
ultrasound scan is the definitive
        decider of dates
IUGR

 Intrauterine growth restriction or Fetal growth restriction

 Leads to uterus < dates
    A manifestation of underlying problem
    Maternal, fetal or placental
    Most commonly caused by placental insufficiency (unknown
      cause), hypertensive disease, maternal disease, fetal anomaly

 Most non-fetal causes lead to asymmetrical FGR (the so-
   called head-sparing effect)
Fetal Growth Restriction
Leads to long term problems
The left ear
Big baby
• If fetal macrosomia is the
  cause in an uterus >
  dates, it is most often a
  consequence of
  gestational diabetes
• GDM can also lead to
  polyhydramnios on its
  own
• It is mandatory to look
  hard for GDM in such
  cases
Macrosomia
Fetal anomalies

 Any discrepancy in uterine size must lead to an extensive
  search for fetal anomalies
Multiples

 Any large uterus may be caused by more than one passenger
  in it

 See for yourself
The diagnosis of SGA

 A constitutionally small fetus is a diagnosis of exclusion
    This is the last diagnosis in your list of differentials

 Always rule out disease before you can say its normal

 These fetuses display linear growth despite being small

 Usually, the mother is also small (this is logical)
Summary
Discrepancy in uterine size

 This denotes a uterine size not corresponding to gestational
   age

 It may be a sign of an underlying problem

 This problem could be of maternal, fetal or placental origin

 One common cause is wrong dates

 Rule out disease before diagnosing a constitutionally small
   fetus
THE END
 Thank You Very Much

Mais conteúdo relacionado

Mais procurados

Abdominal Pain in Pregnancy
Abdominal Pain in PregnancyAbdominal Pain in Pregnancy
Abdominal Pain in Pregnancymeducationdotnet
 
Chorioamnionitis and PROM - Nahrain University
Chorioamnionitis and PROM - Nahrain UniversityChorioamnionitis and PROM - Nahrain University
Chorioamnionitis and PROM - Nahrain UniversityAli Al-Shimmary
 
Abnormal uterine contraction
Abnormal uterine contraction Abnormal uterine contraction
Abnormal uterine contraction Nirsuba Gurung
 
Imperforate anus
Imperforate anus   Imperforate anus
Imperforate anus Mark Gokia
 
Neonatal sepsis
Neonatal sepsis Neonatal sepsis
Neonatal sepsis Azad Haleem
 
Heart disease in pregnancy
Heart disease in pregnancyHeart disease in pregnancy
Heart disease in pregnancyraj kumar
 
Dysfunctional Labour & Partograph
Dysfunctional Labour & PartographDysfunctional Labour & Partograph
Dysfunctional Labour & Partographlimgengyan
 
Bad obstetric history
Bad obstetric historyBad obstetric history
Bad obstetric historylimgengyan
 
Management of abnormal labor & partograph
Management of abnormal labor & partographManagement of abnormal labor & partograph
Management of abnormal labor & partographgelaye mandefro
 
Haemorrhagic disease of newborn
Haemorrhagic disease of newbornHaemorrhagic disease of newborn
Haemorrhagic disease of newbornRabi Dhakal
 
Diabetes Mellitus in Pregnancy
Diabetes Mellitus in PregnancyDiabetes Mellitus in Pregnancy
Diabetes Mellitus in Pregnancymeducationdotnet
 
Pelvic organ prolapse gynaecology ppt
Pelvic organ prolapse gynaecology ppt Pelvic organ prolapse gynaecology ppt
Pelvic organ prolapse gynaecology ppt TONY SCARIA
 

Mais procurados (20)

Abdominal Pain in Pregnancy
Abdominal Pain in PregnancyAbdominal Pain in Pregnancy
Abdominal Pain in Pregnancy
 
Chorioamnionitis and PROM - Nahrain University
Chorioamnionitis and PROM - Nahrain UniversityChorioamnionitis and PROM - Nahrain University
Chorioamnionitis and PROM - Nahrain University
 
Abnormal uterine contraction
Abnormal uterine contraction Abnormal uterine contraction
Abnormal uterine contraction
 
FIRST TRIMESTER BLEEDING
FIRST TRIMESTER BLEEDINGFIRST TRIMESTER BLEEDING
FIRST TRIMESTER BLEEDING
 
Imperforate anus
Imperforate anus   Imperforate anus
Imperforate anus
 
PROM
PROMPROM
PROM
 
Neonatal sepsis
Neonatal sepsis Neonatal sepsis
Neonatal sepsis
 
Cervical stitches
Cervical stitchesCervical stitches
Cervical stitches
 
Shoulder dystocia
Shoulder dystociaShoulder dystocia
Shoulder dystocia
 
Heart disease in pregnancy
Heart disease in pregnancyHeart disease in pregnancy
Heart disease in pregnancy
 
Dysfunctional Labour & Partograph
Dysfunctional Labour & PartographDysfunctional Labour & Partograph
Dysfunctional Labour & Partograph
 
Abdominal pain during_pregnancy
Abdominal pain during_pregnancyAbdominal pain during_pregnancy
Abdominal pain during_pregnancy
 
Bad obstetric history
Bad obstetric historyBad obstetric history
Bad obstetric history
 
Abnormal labor
Abnormal laborAbnormal labor
Abnormal labor
 
Uterine prolapse
Uterine prolapseUterine prolapse
Uterine prolapse
 
UTIs in pregnancy
UTIs in pregnancyUTIs in pregnancy
UTIs in pregnancy
 
Management of abnormal labor & partograph
Management of abnormal labor & partographManagement of abnormal labor & partograph
Management of abnormal labor & partograph
 
Haemorrhagic disease of newborn
Haemorrhagic disease of newbornHaemorrhagic disease of newborn
Haemorrhagic disease of newborn
 
Diabetes Mellitus in Pregnancy
Diabetes Mellitus in PregnancyDiabetes Mellitus in Pregnancy
Diabetes Mellitus in Pregnancy
 
Pelvic organ prolapse gynaecology ppt
Pelvic organ prolapse gynaecology ppt Pelvic organ prolapse gynaecology ppt
Pelvic organ prolapse gynaecology ppt
 

Semelhante a Discrepancy in Uterine Size

Discrepancy in uterine size
Discrepancy in uterine sizeDiscrepancy in uterine size
Discrepancy in uterine sizeHanifullah Khan
 
Getting Pregnant While Breastfeeding
Getting Pregnant While BreastfeedingGetting Pregnant While Breastfeeding
Getting Pregnant While BreastfeedingBiblioteca Virtual
 
Miscarriage - medical information(causes ,test& diagnosis, management , preve...
Miscarriage - medical information(causes ,test& diagnosis, management , preve...Miscarriage - medical information(causes ,test& diagnosis, management , preve...
Miscarriage - medical information(causes ,test& diagnosis, management , preve...martinshaji
 
Understanding the benefits &amp; risks of ivf treatment
Understanding the benefits &amp; risks of ivf treatmentUnderstanding the benefits &amp; risks of ivf treatment
Understanding the benefits &amp; risks of ivf treatmentivfmeerut
 
Am I Pregnant
Am I Pregnant Am I Pregnant
Am I Pregnant gobs4u
 
Sci-tech project by Kenzie Cook
Sci-tech project by Kenzie CookSci-tech project by Kenzie Cook
Sci-tech project by Kenzie CookDebbie Cook
 
Problems-with-the-passage.pptx
Problems-with-the-passage.pptxProblems-with-the-passage.pptx
Problems-with-the-passage.pptxMaritesTarucan
 
Abnormal lie & presentations; basic concepts
Abnormal lie & presentations; basic conceptsAbnormal lie & presentations; basic concepts
Abnormal lie & presentations; basic conceptsHanifullah Khan
 
Chapter 23
Chapter 23Chapter 23
Chapter 23csirard
 
THIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptx
THIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptxTHIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptx
THIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptxThivyaroobini1
 
Augmentation of labour-Clinical Teaching
Augmentation of labour-Clinical Teaching Augmentation of labour-Clinical Teaching
Augmentation of labour-Clinical Teaching sonal patel
 
pi-multiple-pregnancy-large-print.pdf
pi-multiple-pregnancy-large-print.pdfpi-multiple-pregnancy-large-print.pdf
pi-multiple-pregnancy-large-print.pdfPalindaWetthasinghe1
 
HHG Unit Two SummativeExamining the Impacts of Maternal
HHG  Unit Two SummativeExamining the Impacts of MaternalHHG  Unit Two SummativeExamining the Impacts of Maternal
HHG Unit Two SummativeExamining the Impacts of MaternalSusanaFurman449
 
Women Need Support
Women Need SupportWomen Need Support
Women Need SupportJP Dadhich
 
Women Need Support To Breastfeed Successfully
Women Need Support To Breastfeed SuccessfullyWomen Need Support To Breastfeed Successfully
Women Need Support To Breastfeed SuccessfullyBiblioteca Virtual
 
Signs of Infertility
Signs of InfertilitySigns of Infertility
Signs of Infertilitymtviva
 
Make Birth Better Training 2019 Julianne Boutaleb Infant Mental ealth
Make Birth Better Training 2019 Julianne Boutaleb Infant Mental ealthMake Birth Better Training 2019 Julianne Boutaleb Infant Mental ealth
Make Birth Better Training 2019 Julianne Boutaleb Infant Mental ealthMake Birth Better
 

Semelhante a Discrepancy in Uterine Size (20)

Discrepancy in uterine size
Discrepancy in uterine sizeDiscrepancy in uterine size
Discrepancy in uterine size
 
1 Labour II Intro.ppt
1 Labour II Intro.ppt1 Labour II Intro.ppt
1 Labour II Intro.ppt
 
Getting Pregnant While Breastfeeding
Getting Pregnant While BreastfeedingGetting Pregnant While Breastfeeding
Getting Pregnant While Breastfeeding
 
Miscarriage - medical information(causes ,test& diagnosis, management , preve...
Miscarriage - medical information(causes ,test& diagnosis, management , preve...Miscarriage - medical information(causes ,test& diagnosis, management , preve...
Miscarriage - medical information(causes ,test& diagnosis, management , preve...
 
Understanding the benefits &amp; risks of ivf treatment
Understanding the benefits &amp; risks of ivf treatmentUnderstanding the benefits &amp; risks of ivf treatment
Understanding the benefits &amp; risks of ivf treatment
 
5 Contraction Patterns of Labour
5 Contraction Patterns of Labour5 Contraction Patterns of Labour
5 Contraction Patterns of Labour
 
Am I Pregnant
Am I Pregnant Am I Pregnant
Am I Pregnant
 
Sci-tech project by Kenzie Cook
Sci-tech project by Kenzie CookSci-tech project by Kenzie Cook
Sci-tech project by Kenzie Cook
 
Problems-with-the-passage.pptx
Problems-with-the-passage.pptxProblems-with-the-passage.pptx
Problems-with-the-passage.pptx
 
Abnormal lie & presentations; basic concepts
Abnormal lie & presentations; basic conceptsAbnormal lie & presentations; basic concepts
Abnormal lie & presentations; basic concepts
 
Chapter 23
Chapter 23Chapter 23
Chapter 23
 
THIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptx
THIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptxTHIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptx
THIVYAROOBINI PRESENTATION ABNORMAL LABOUR .pptx
 
Women Need Support
Women Need SupportWomen Need Support
Women Need Support
 
Augmentation of labour-Clinical Teaching
Augmentation of labour-Clinical Teaching Augmentation of labour-Clinical Teaching
Augmentation of labour-Clinical Teaching
 
pi-multiple-pregnancy-large-print.pdf
pi-multiple-pregnancy-large-print.pdfpi-multiple-pregnancy-large-print.pdf
pi-multiple-pregnancy-large-print.pdf
 
HHG Unit Two SummativeExamining the Impacts of Maternal
HHG  Unit Two SummativeExamining the Impacts of MaternalHHG  Unit Two SummativeExamining the Impacts of Maternal
HHG Unit Two SummativeExamining the Impacts of Maternal
 
Women Need Support
Women Need SupportWomen Need Support
Women Need Support
 
Women Need Support To Breastfeed Successfully
Women Need Support To Breastfeed SuccessfullyWomen Need Support To Breastfeed Successfully
Women Need Support To Breastfeed Successfully
 
Signs of Infertility
Signs of InfertilitySigns of Infertility
Signs of Infertility
 
Make Birth Better Training 2019 Julianne Boutaleb Infant Mental ealth
Make Birth Better Training 2019 Julianne Boutaleb Infant Mental ealthMake Birth Better Training 2019 Julianne Boutaleb Infant Mental ealth
Make Birth Better Training 2019 Julianne Boutaleb Infant Mental ealth
 

Mais de Hanifullah Khan

Mais de Hanifullah Khan (20)

Obstetric Terminology
Obstetric Terminology Obstetric Terminology
Obstetric Terminology
 
Dysmenorrhea
DysmenorrheaDysmenorrhea
Dysmenorrhea
 
Gestational chart
Gestational chartGestational chart
Gestational chart
 
The Primary Care Physician's guide to management of Pregnancy Diabetes
The Primary Care Physician's guide to management of Pregnancy DiabetesThe Primary Care Physician's guide to management of Pregnancy Diabetes
The Primary Care Physician's guide to management of Pregnancy Diabetes
 
CONTRACEPTION OVERVIEW
CONTRACEPTION OVERVIEWCONTRACEPTION OVERVIEW
CONTRACEPTION OVERVIEW
 
Gestational Age & EDD
Gestational Age & EDDGestational Age & EDD
Gestational Age & EDD
 
Obstetric History I
Obstetric History IObstetric History I
Obstetric History I
 
DM in pregnancy 5 points
DM in pregnancy 5 pointsDM in pregnancy 5 points
DM in pregnancy 5 points
 
The Low Down on Anaemia in Pregnancy
The Low Down on Anaemia in PregnancyThe Low Down on Anaemia in Pregnancy
The Low Down on Anaemia in Pregnancy
 
Diabetes In Pregnancy
Diabetes In PregnancyDiabetes In Pregnancy
Diabetes In Pregnancy
 
Evaluate pelvic tumours
Evaluate pelvic tumoursEvaluate pelvic tumours
Evaluate pelvic tumours
 
Menopause overview
Menopause overviewMenopause overview
Menopause overview
 
Obs Hx &amp; W U + sample History
Obs  Hx &amp;  W U + sample HistoryObs  Hx &amp;  W U + sample History
Obs Hx &amp; W U + sample History
 
Obs Hx &amp; W U + Eg
Obs  Hx &amp;  W U + EgObs  Hx &amp;  W U + Eg
Obs Hx &amp; W U + Eg
 
Contraception
ContraceptionContraception
Contraception
 
Practical partography
Practical partographyPractical partography
Practical partography
 
Pelvic Pain
Pelvic  PainPelvic  Pain
Pelvic Pain
 
Obs Hx &amp; W U
Obs  Hx &amp;  W UObs  Hx &amp;  W U
Obs Hx &amp; W U
 
Abnormal lie & presentation
Abnormal lie & presentationAbnormal lie & presentation
Abnormal lie & presentation
 
GDM
GDMGDM
GDM
 

Último

AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsMedicoseAcademics
 
Microbiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptxMicrobiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptxkitati1
 
World-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptxWorld-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptxsumanchaulagain3
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu Medical University
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptPradnya Wadekar
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptxWINCY THIRUMURUGAN
 
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...Ganesan Yogananthem
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Vaikunthan Rajaratnam
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaSujoy Dasgupta
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .Mohamed Rizk Khodair
 
concept of total quality management (TQM).
concept of total quality management (TQM).concept of total quality management (TQM).
concept of total quality management (TQM).kishan singh tomar
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfDolisha Warbi
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyMedicoseAcademics
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...Shubhanshu Gaurav
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentsaileshpanda05
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfHongBiThi1
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondSujoy Dasgupta
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)kishan singh tomar
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024EwoutSteyerberg1
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.kishan singh tomar
 

Último (20)

AUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functionsAUTONOMIC NERVOUS SYSTEM organization and functions
AUTONOMIC NERVOUS SYSTEM organization and functions
 
Microbiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptxMicrobiology lecture presentation-1.pptx
Microbiology lecture presentation-1.pptx
 
World-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptxWorld-TB-Day-2023_Presentation_English.pptx
World-TB-Day-2023_Presentation_English.pptx
 
historyofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusanguhistoryofpsychiatryinindia. Senthil Thirusangu
historyofpsychiatryinindia. Senthil Thirusangu
 
Unit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.pptUnit I herbs as raw materials, biodynamic agriculture.ppt
Unit I herbs as raw materials, biodynamic agriculture.ppt
 
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptxANATOMICAL FAETURES OF BONES  FOR NURSING STUDENTS .pptx
ANATOMICAL FAETURES OF BONES FOR NURSING STUDENTS .pptx
 
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
QUESTIONS & ANSWERS FOR QUALITY ASSURANCE, RADIATIONBIOLOGY& RADIATION HAZARD...
 
Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.Generative AI in Health Care a scoping review and a persoanl experience.
Generative AI in Health Care a scoping review and a persoanl experience.
 
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy DasguptaMale Infertility Panel Discussion by Dr Sujoy Dasgupta
Male Infertility Panel Discussion by Dr Sujoy Dasgupta
 
Neurological history taking (2024) .
Neurological  history  taking  (2024)  .Neurological  history  taking  (2024)  .
Neurological history taking (2024) .
 
concept of total quality management (TQM).
concept of total quality management (TQM).concept of total quality management (TQM).
concept of total quality management (TQM).
 
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdfCONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
CONNECTIVE TISSUE (ANATOMY AND PHYSIOLOGY).pdf
 
Female Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before PregnancyFemale Reproductive Physiology Before Pregnancy
Female Reproductive Physiology Before Pregnancy
 
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
 
CPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing studentCPR.nursingoutlook.pdf , Bsc nursing student
CPR.nursingoutlook.pdf , Bsc nursing student
 
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdfSGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
SGK RỐI LOẠN KALI MÁU CỰC KỲ QUAN TRỌNG.pdf
 
Male Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and BeyondMale Infertility, Antioxidants and Beyond
Male Infertility, Antioxidants and Beyond
 
High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)High-Performance Thin-Layer Chromatography (HPTLC)
High-Performance Thin-Layer Chromatography (HPTLC)
 
Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024Trustworthiness of AI based predictions Aachen 2024
Trustworthiness of AI based predictions Aachen 2024
 
Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.Different drug regularity bodies in different countries.
Different drug regularity bodies in different countries.
 

Discrepancy in Uterine Size

  • 1. DISCREPANCY IN UTERINE SIZE An understanding of the issues involved when a uterus doesn’t correspond to its gestational age
  • 2. By Associate Professor Dr Hanifullah Khan
  • 3. Objectives  To understand the  To understand the  The important points to definitions involved implications of this situation consider
  • 4. Discrepancy – what is it? When the uterine size does not correspond to the expected gestation May be larger or smaller Objective measurement - > 2 cm variation with symphysiofundal height (SFH)
  • 5. Is there an Is there a underlying problem with problem causing the mother? this discrepancy? Is the fetus at Has there been a risk? mistake in calculating • If so, when do we deliver it? gestation? Implications of this situation
  • 6. Points to consider  The patient has been found to have a gestation which does not correspond to calculations.  This may be a feature of an underlying problem  The problem may be related to the mother, fetus or placenta  It is our job to determine the underlying cause of this problem
  • 7. In all cases, always begin by Dates confirming the dates Be absolutely positive The mother remembers the exact LMP (1st day) The periods have been regular The onset of pregnancy symptoms & quickening correspond to the dates That an early pregnancy ultrasound (if done), confirmed the dates Subsequent antenatal check ups have noted previous corresponding growth of
  • 8. Remember, an early pregnancy ultrasound scan is the definitive decider of dates
  • 9. IUGR  Intrauterine growth restriction or Fetal growth restriction  Leads to uterus < dates  A manifestation of underlying problem  Maternal, fetal or placental  Most commonly caused by placental insufficiency (unknown cause), hypertensive disease, maternal disease, fetal anomaly  Most non-fetal causes lead to asymmetrical FGR (the so- called head-sparing effect)
  • 10. Fetal Growth Restriction Leads to long term problems
  • 12. Big baby • If fetal macrosomia is the cause in an uterus > dates, it is most often a consequence of gestational diabetes • GDM can also lead to polyhydramnios on its own • It is mandatory to look hard for GDM in such cases
  • 14. Fetal anomalies  Any discrepancy in uterine size must lead to an extensive search for fetal anomalies
  • 15. Multiples  Any large uterus may be caused by more than one passenger in it  See for yourself
  • 16. The diagnosis of SGA  A constitutionally small fetus is a diagnosis of exclusion  This is the last diagnosis in your list of differentials  Always rule out disease before you can say its normal  These fetuses display linear growth despite being small  Usually, the mother is also small (this is logical)
  • 18. Discrepancy in uterine size  This denotes a uterine size not corresponding to gestational age  It may be a sign of an underlying problem  This problem could be of maternal, fetal or placental origin  One common cause is wrong dates  Rule out disease before diagnosing a constitutionally small fetus
  • 19. THE END  Thank You Very Much