LBW & IUGR

Question 1

Any baby that weighs less than ______kg at birth is termed Low birth weight baby by W.H.O

This include _________ babies, babies with _________ and _________ babies

Answer 1

2.5kg

preterm babies

IUGR

small for gestational babies (SGA).

Question 2

Definition & Classification of
Terminology about birth

• preterm birth: Birth before _______ weeks gestation

• Small for gestational a g e (SGA) or small for dates:
A fetus or newborn whose weight ___________________________ of birth weight for gestational age, sex-
specific, singleton/twin risk curve

• Appropriate for gestational age (AGA): A fetus or Newborn whose weight __________ the cut-off
point chosen to define SGA

Answer 2

37

falls below 10th percentile

falls above

Question 3

Classification & Definition of Low birth
weight
• Low birth weight
• Very Low birth weight
• Extreme Low birth weight

Answer 3

1500-2499 g m s

1000-1499 g m s

≤ 999gms

Question 4

Relative -birth-weight-ratio: Here birth weight is
Expressed as a fraction or percentage of mean birth weight for gestational age.

A relative-birth-weight-ratio of less than ______ (<____%) roughly
Correlates with SGA.

Answer 4

0.85

85

Question 5

In the developed countries, two-thirds of the LBW infants are _____ births

• In developing countries, two-thirds of LBW are _____ births, about one-quarter of all infants have
Suffered _________ before birth and preterm babies are also growth restricted.

Answer 5

preterm

term

growth restriction

Question 6

Intrauterine Growth Restriction (IUGR):
Current definition u s e s indices of ‘_________[’ such as _______________.

Answer 6

thinnes; body mass index

Question 7

A value more than _________ standard deviation below the mean is classified as IUGR

Answer 7

Two

Question 8

IUGR is m synonymous with SGA.

Answer 8

F

IUGR is not synonymous with SGA.

Question 9

A newborn with IUGR shows signs of ___________ where as SGA newborn infant may simply be _______________

Answer 9

nutritional deprivation

small but healthy

Question 10

INTRAUTERINE GROWTH RESTRICTION
• The weight of the baby is influenced by 2 major factors:
1. The maximum _________ for that particular fetus and this is genetically predetermined.
2. The efficiency of the mechanism for _________ and _______ transfer (from mother to fetus) through the placenta which depend on
nutrition & health state of the mother as well as ________ function.

Answer 10

growth potential

nutrient and energy

placental

Question 11

The diagnosis of IUGR can be made
ultrasonography by _________ measurement of ______________ and ________________ .

When biparietal diameter or head - abdominal circumference ratio of a baby measured on ________ consecutive times about _______ weeks apart is found to be below the _______ percentile for the population.

Answer 11

serial

cephalometry (head circumference)

abdominal circumference; two; two

fifth

Question 12

Symmetrical IUGR: baby is __________________ and usually of _____ origin.

Asymmetrical IUGR: a ___________ effect occurs, the fetal head shows a ______ loss of growth rate than the body. This is thought to Be due to _________________.

Answer 12

proportionally small

fetal; head sparing ; smaller

poor placental perfusion.

Question 13

Mothers at risk of having LBW babies
1. Parity: ___________ ; ___________ women
2. Age: < 2 0 y e a r s ; > 35 y e a r s
3. _______ socioeconomic class.
4. Previous maternal history of __________ , __________ cervix, PROM
5. Pregnancy complications e,g PIH, APH etc
6. Maternal disease e.g. Chronic hypertension, CRD, SCD, DM

Answer 13

Primigravida; grandmultiparous

Low; miscarriage,

incompetent

Question 14

Mothers at risk of having LBW babies
7. ________ pregnancy
8. History of smoking or drug addiction
9. Idiopathic (Unknown). In over ______% of cases,
t h e c a u s e of LBW is unknown.

Answer 14

Multiple; 50

Question 15

Management of IUGR
• ________ is often advised as it is to
Improve utero placental circulation.
• Fetal _______ ( Cardiff count to 10).
• Non Stress Test (__________________)

Answer 15

Bed rest ; kick chart

Antenatal Cardiotocography

Question 16

Management of IUGR
•________________ can be used to monitor growth restricted fetus. ________ or ________ end diastolic flow is an ominous sign of imminent fetal demise & urgent delivery is
essential.
•_________ _________

Answer 16

Umbilical artery Doppler

Absent or Reversed

Biophysical Profile

Question 17

Mode of Delivery
• These babies cannot withstand _________ labour & if vaginal delivery is opted for, labour must be
well supervised & ________.
• The mode of delivery is however dependent on factors like age, parity, obstetric history etc

Answer 17

prolonged; short

Question 18

Most of the babies with IUGR are better delivered by ___________ especially if there are other
Conditions in addition to IUGR.

• Delivery should b e in a well equipped hospital with ___________ around to take care of the baby after delivery in special care baby unit.

Answer 18

Caesarean section

Neonatologist

Question 19

Complications of LBW/IUGR
They are predisposed to:
•___________
•____________
•____________
• Perinatal mortality & morbidity
• They are at increased risk of cardiovascular
disease & diabetes mellitus in adulthood.

Answer 19

Perinatal asphyxia.

Hypoglycaemia

Hypothermia