Antepartum Therapy for IUGR and Pre-eclampsia
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Questions and Answers

What is the recommended management for early intrauterine growth restriction (IUGR)?

  • Venous circulation assessment
  • Amniocentesis for karyotyping and TORCH testing
  • Antepartum fetal testing
  • Detailed ultrasound (correct)
  • Which factor warrants maintaining a high index of suspicion in cases of oligohydramnios?

  • Post-term pregnancy
  • Fetal macrosomia
  • Aneuploidy (correct)
  • Maternal diabetes
  • What should be included in the surveillance plan for monitoring fetal well-being in IUGR cases?

  • Cordocentesis
  • Early IUGR evaluation
  • Doppler ultrasound assessment (correct)
  • Antenatal testing at viability
  • What is a common adverse outcome associated with intrauterine growth restriction (IUGR)?

    <p>Polycythemia</p> Signup and view all the answers

    Which fetal parameter is not typically included in the surveillance plan for IUGR?

    <p>Cordocentesis</p> Signup and view all the answers

    What type of Doppler is recommended for assessing fetal blood flow in cases of intrauterine growth restriction (IUGR)?

    <p>Umbilical artery Doppler</p> Signup and view all the answers

    In cases where a significant proportion of the villous vascular tree is abnormal, what can be observed in terms of end-diastolic velocities?

    <p>Moderate reversal</p> Signup and view all the answers

    What is indicated by the persistence of an early diastolic notch in the uterine artery flow velocity waveform?

    <p>Increased spiral artery blood flow resistance</p> Signup and view all the answers

    What is the significance of a high-volume diastolic flow in the uterine artery beyond 24 weeks gestation?

    <p>Successful trophoblast invasion</p> Signup and view all the answers

    What does the decline in diastolic velocities associated with elevated placental vascular resistance lead to?

    <p>Increase in Doppler index</p> Signup and view all the answers

    What is indicated by abnormal precordial venous flows in cases where reversal of end-diastolic velocities is present?

    <p>Decreased fetal cardiac function</p> Signup and view all the answers

    What is the significance of a low-impedance waveform with no diastolic notch in the uterine artery by 20 weeks gestation?

    <p>Low risk of IUGR and preeclampsia</p> Signup and view all the answers

    What is the main difference in fetal growth between the first 16 weeks and beyond 32 weeks?

    <p>Both hyperplasia and hypertrophy during the first 16 weeks, with only hypertrophy beyond 32 weeks</p> Signup and view all the answers

    What factors can influence intrauterine growth according to the provided text?

    <p>Altitude, race, and smoking</p> Signup and view all the answers

    What is a characteristic of symmetric Intrauterine Growth Restriction (IUGR) according to the text?

    <p>Proportionally small fetus with abnormal head circumference, abdominal circumference, and femur length</p> Signup and view all the answers

    What distinguishes Asymmetric IUGR from Symmetric IUGR?

    <p>Asymmetric IUGR shows slow abdominal circumference growth but normal head circumference and femur length</p> Signup and view all the answers

    Which condition is associated with Tri 13 according to the text?

    <p>Asymmetric IUGR</p> Signup and view all the answers

    What is an important ultrasound measurement for diagnosing IUGR according to the text?

    <p>Transcerebellar distance</p> Signup and view all the answers

    What happens to the Doppler index in cases of marked brain sparing in IUGR?

    <p>Declines</p> Signup and view all the answers

    What is a potential indicator of an abnormal Doppler index in fetal circulation?

    <p>Decrease in diastolic velocity</p> Signup and view all the answers

    How does cerebral edema impact the Indices PI and RI?

    <p>PI decreases</p> Signup and view all the answers

    In the normal fetal thoracic aorta, what range of Pulsatility Index (PI) values are observed from 20 to 40 weeks?

    <p>1.8 - 2.2</p> Signup and view all the answers

    What characterizes the blood flow pattern in the ductus venosus under normal circumstances?

    <p>Antegrade flow throughout the cardiac cycle</p> Signup and view all the answers

    How is the Doppler index affected by increased resistance in IUGR in reference to the middle cerebral artery?

    <p>Decreases</p> Signup and view all the answers

    What is the effect of low dose aspirin, according to Leitich et al 1997 meta-analysis?

    <p>Decrease in I.U.G.R. and pre-eclampsia</p> Signup and view all the answers

    What is recommended as the basis for decision-making in case of preterm I.U.G.R.?

    <p>Maternal health, fetal function tests, biochemical test of fetal lung maturity</p> Signup and view all the answers

    What is the association observed between high resistance and IUGR involving the umbilical artery?

    <p>Trudinger, 1985</p> Signup and view all the answers

    What percentage of precipitating antenatal asphyxia can be predicted by positive postnatal ventilation (PPV)?

    <p>92%</p> Signup and view all the answers

    What characteristic describes a normal umbilical artery flow velocity waveform?

    <p>Marked positive end-diastolic velocity increasing towards term</p> Signup and view all the answers

    'Moderate abnormalities in the villous vascular structure' lead to what in terms of blood flow resistance and end-diastolic velocities?

    <p>Raise the blood flow resistance and decline in end-diastolic velocities</p> Signup and view all the answers

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