Large for dates

Question 1

Clinical presentations

Answer 1

Usually none
Breathlessness->polyhydramnios
++Vomiting->multiples, trophoblastic disease

Question 2

Examination

Answer 2

+fundal height

+palpable fetal parts if multiples

Question 3

Differential (6)

Answer 3

Incorrect
Obesity
Polyhydramnios
Accelerated growth
Multiples
Molar pregnancy

Question 4

Definition of polyhydramnios

Answer 4

Max AFI >8cm

Fluid >20 cm

Question 5

Cause of polyhydramnios

Answer 5

Multiples
Maternal->GDM
Neonatal:
Gastroduoneal atresia, compression
Neurological, swallowing
Hydrops
Infection->TORCH, Syphillis
Twin to twin transfusion
Placental:
Chorioangioma

Question 6

Investigations for polyhydramnios

Answer 6

USS
GTT
Infection screen

Question 7

Complications of polyhydramnios

Answer 7

Preterm
Placental abruption
Unstable lie
Abnormal presentation
Cord prolapse
Uterine atony

Question 8

Management of polyhydramnios

Answer 8

Treat underlying

Amnioreduction->may need repeated drainage

Question 9

Define macrosomia

Answer 9

Weight >90th centile, >4000-4500g

Question 10

Complications of macrosomia

Answer 10

Obstructed labour
Birth trauma
Shoulder dystocia