This is a brief video on fetal growth abnormalities, including babies and fetuses that are too small and too large.
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By Yehudamalul - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=8980869
LGA = weight above 90th%
Diagnosed with fetal ultrasound
Risk factors: (gestational) diabetes, obesity, maternal weight gain, advanced maternal age, male female, genetic disorders of overgrowth (Beckwithâ€“ Wiedemann syndrome)
Macrosomia (literally big body) - baby weighing over 4000-4500 g
Complications include shoulder dystocia and other birth trauma, jaundice, poor APGAR, hypoglycemia in neonatal period
SGA = weight below 10th%
Intrauterine growth restriction (IUGR) = fail to achieve potential size
Symmetric:asymmetric â†’ 20%:80%
Asymmetric = abdomen smaller than head
Fundal height 3 cm smaller than expected
Risk factors: maternal htn, diabetes, SLE, CVD; placental infarction, abruption, velamentous cord (insert into fetal membranes, travel between amnion and chorion
Causes: teratogens, smoking, alcohol, cocaine, htn, preeclampsia, infections (CMV, rubella, etc), anemia, multiple gestations, genetic/chromosomal abnormalities, poor placental perfusion, poor nutrition, anatomic abnormalities.
Identify cause with karyotype, ultrasound, infection screens
Monitor baby with ultrasounds, nonstress tests, doppler velocimetry
Bed rest not found to improve outcomes
Induce delivery if fetus in distress, momâ€™s health is in danger, baby continues to drop off growth curve
Smaller infant has greater morbidity and mortality
LBW low birth weight - less than 2500 g (5 lb 8 oz)
very low birth weight VLBW - less than 1500 g (3 lb 5 oz)
extremely low birth weight ELBW - less than 1000 g (2 lb 3 oz)