Small for gestational age

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Information about Small for gestational age
Science-Technology

Published on December 16, 2008

Author: ravimohanv

Source: authorstream.com

Small for gestational age : Small for gestational age Dr.V.Ravimohan SpR http://www.mrcogexam.net Slide 2: Thank you Visit my site http://www.mrcogexam.net Slide 3: Definition Implications Causes Diagnosis management Definition : Definition SGA refers to a fetus that has failed to achieve a specific biometric or estimated weight threshold by a specific gestational age. One of most frequently sited suboptimal care is the failure : One of most frequently sited suboptimal care is the failure to suspect growth restriction in a mother with a previous history to detect to act on to monitor Implications : Implications stillbirth birth hypoxia neonatal complications Neurodevelopment delay type 2 (non-insulin-dependent) diabetes and hypertension in adult life. Slide 7: Ott Wj.The diagnosis of altered fetal growth.Obstet Gynecol Clin North Am 1988;15:237-63 Improving sensitivity… : Improving sensitivity… Use customised ultrasound charts(maternal weight, maternal height, ethnic group and parity) Use growth velocity in addition to size Management : Management (I) aetiology(ex.chromosomal defects) (ii)arrange surveillance (iii) delivery- when? how? where? Causes of Growth restriction : Causes of Growth restriction High risk pregnancy management options 2nd edition p300 Chromosomal abnormalities : Chromosomal abnormalities Surveillance : Surveillance Umbilical artery doppler is the primary surveillance tool frequency of monitoring in SGA fetuses with normal Doppler need not generally be more than once every fortnight. Doppler indices : Doppler indices <34 weeks with RED/AED : <34 weeks with RED/AED Daily CTG/Biophysical profile/Venous doppler Consider delivery Pathological CTG Biophysical score <4 Reversal of doppler velocities in ductus venosus during atrial contraction or umbilical vein pulsations Slide 20: My web site:www.mrcogexam.net MY blog :http://mrcogfacts.blogspot.com/ Survival by birth weight : Survival by birth weight Survival by gestation : Survival by gestation Growth Restriction Intervention Trial (GRIT) : Growth Restriction Intervention Trial (GRIT) Hypothesis:early delivery,to pre-empt intrauterine hypoxia,would alter brain development compared with delaying delivery for as long as possible ,to gain maturity. OR 1.1(0.7-1.8) : OR 1.1(0.7-1.8) Conclusion : Conclusion The present study should discourage doctors who deliver fetuses (<30 weeks) before at which they delivery can be delayed no longer. Mode of delivery : Mode of delivery Indications for LSCS (I)late decelerations in antenatal CTG (II)Reversed End diastolic flow (III)thick meconium during induction of labour Clinical obstetrics and Gynaecology 40:4:1997;p822 Summary : Summary Definition Implications Causes Diagnosis management

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