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Fetal growth

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Fetal growth

  1. 1. Fetal growth 8th December 2013
  2. 2. Fetal growth Intrauterine fetal growth abnormality > fetal abnormalities Failure to detect --> neonatal morbidity to IUD Causes: Utero placental insufficiency Chromosomal abnormalities Fetal abnormality Fetal infection
  3. 3. IUGR Features of IUGR on ultrasound: Reduction in growth velocity Oligohydramnios Reduced bio-physical profile Mild cardiomegaly Hyperechoic bowel and dilatation Doppler changes
  4. 4. IUGR
  5. 5. IUGR DEFINITION: Birth weight <10th centile for gestational age Problem: 10% normal also included The majority of fetuses with uteroplacental insufficiency has measurement above 10th centile
  6. 6. IUGR Solution: Better to use customised growth chart Based on mother's weight, parity, birth wt of previous children E.g. A fetus that weighs 2.9kg at 39 w is probably growth restricted if mother is 6ft tall, weighs 65kg and has a previous child weighing 4.2kg at birth
  7. 7. IUGR Growth velocity: A fetus with falling growth velocity that is crossing centile lines Correct pregnancy dating is essential
  8. 8. IUGR Symmetrical growth restriction: Equivalent reduction in growth velocity of both fetal head circumference & abd circumference (H:A ratio)
  9. 9. Distinguishing between normal and abnormal pregnancy Constitutionally small fetus- growth velocity continues on same centile
  10. 10. Pathologically small fetuses: Growth velocity continues to fall and cross lower centiles
  11. 11. IUGR Asymmetrical growth restriction: Differential reduction in growth velocities of the fetal head to abd circumference = uteroplacental insufficiency
  12. 12. Biophysical profile < 6 - abnormal 7-8 - suspicious