All of the following are risk factors for IUGR except
Correct Answer: Maternal diabetes
Description: In maternal diabetes fetal macrosomia is common. IUGR, if at all, is seen in neglected 'Burnt out' kind of diabetes with microangiopathy and is the last association which should come to mind with Diabetes in pregnancy Defn of IUGR: also called Fetal Growth Restriction ( FGR) Fetuses with estimated weight below the 10th percentile for their gestational ages. The femur to abdomen ratio remains constant after 20 weeks. The normal value for this index is 22 +/- 2. An upper limit of 23.5 (90th percentile) strongly suggests the diagnosis of FGR HC/AC ratio. This ratio compares the most preserved organ in the malnourished fetus, the brain, represented by the circumference of the fetal head, with the most compromised organ, the liver, represented by the fetal AC. This measurement is of significant value in identifying FGR babies with asymmetric head to abdomen measurements. Pathological restriction of the fetal growth is usually present when the H/A ratio is above the 95th percentile for the gestational age. The Fetal Ponderel Index (FPI) is gestational age-independent and has a constant value throughout the second pa of the pregnancy. The FPI is obtained by dividing the estimated fetal weight by the third power of the FL and its normal value is 8.325 +/- 2.5 (2 SD). An FPI of 7.0 or less should be considered abnormal and suggestive of PFGR. Type I or symmetric FGR corresponds to foetuses that are symmetrically small and have normal HC/AC and FL/AC ratios. Early onset, congenital anomalies, chromosomal defects, Poor prognosis Type II or asymmetric FGR corresponds to fetuses that have an AC that is smaller than the HC and the FL resulting in abnormally high H/A and F/A ratios. Late onset, diseases like PIH, good prognosis Type III or intermediate FGR corresponds to fetuses that are initially symmetric but become asymmetric later in the pregnancy.
Category:
Gynaecology & Obstetrics
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