Chapter 53 Fetal Growth Assesment by
Sonography(100% Correct answers)
What will birth weight help with figuring out? correct answersif its small for gestational age
SGA or large for gestational age LGA
What is intrauterine growth restriction (UGR) or fetal growth restriction (FGR). correct answersa
decresed rate of fetal growth
What are IUGR babies in greater risk of? correct answersAntepartum death, perinatal asphyxia
( body deprived of oxygen cause unconsciousness or death), Neonatala morbidity, and later
developmental problems.
What are the most significant maternal factors for IUGR? correct answersHistory of a previous
fetus with IUGR, significant maternal hypertension or smoking, The presence of a uterine
anomaly (bicornuate uterus or large leiomyoma) and significant placental hemorrhage.
What is the difference of IUGR and SGA? correct answersSGA is the fetus with a weight below
the 10th percentile without reference to the cause. Fetal growth restriction is a subset of the SGA
fetuses with a weight below the 10th percentile as a result of pathological processes resulting
from a variety of maternal, fetal aor placental disorders.
THE SGA fetus may be normal but constitutionally small, but a fetus with IUGR is ill and does
not follow a normal growth trajectory. The fetal. Size lagging farther and farther behind the
expected growth rate.
What is the difference between Symmetric and asymmetric IUGR? correct answersSymmetric
IUGR is usually the result of a first-trimester insult, such as a chromosomal abnormality or
infection, Fetus is usually proportionately small throughout pregnancy.
Asymmetric IUGR generally begins in the second or third trimester and usually results from
placental insufficiency, This fetus usually shows head sparing at the expense of abdominal and
soft tissue growth .
What could cause Symmetric growth restriction? correct answersLow genetic growth potentia,
intrauterine infection, severe maternal malnutrition, fetal alcohol syndrome, chromosomal
anomaly, or severe congenital anomaly
What could cause Asymmetric growth restriction? correct answersCould be the result of
maternal disease, such as diabetes (classes D-F), Chronic hypertension, cardiac or renal disease,
abruptio placentae, multiple pregnancy, smoking, poor weigh gain, drug use, or uterine anomaly.
Still all normal non high risk mother could still be born with it. All pregnancies undergoing
sonographic examinations should be evaluated for IUGR
What does Asymmetric IUGR measurement have different? correct answersIt will have the
appropriate BPD and HD but disproportionately small AC , this reinforces the BRAIN-
SPARING effect.
, What is Brain Sparing effect? correct answersThe body tries to keep the brain alive and give as
much nutrients to it, depriving the body of it to be able to keep it alive.
Multiple parameters for intrauterine growth restriction IUGR correct answersBPD. Imaged in the
transverse plane using the cavum septi pellucidi, thalamic nuclei, falx cerebri, and choroid plexus
as landmarks. The BPD can be misleading in cases associated with unusual head shapes. Used
alone, it is a poor indicator of IUGR.
HC to AC ratio. High false-positive rate for use in screening
general population. The HC to AC ratio is useful in determining the type of IUGR.
FL to AC ratio. Not dependent on knowing gestational age. The FL to AC ratio has a poor
positive predictive value.
FL. May decrease in size with symmetric IUGR.
AC. Measure at level of portal-umbilical venous complex. When
growth is compromised, AC is affected secondary to reduced adipose tissue and depletion of
glycogen storage in liver. AC is the single most sensitive indicator of IUGR.
What does Dolichocephaly do to the BPD? correct answersIt falsely shortened BPD, can lead to
underestimation of the fetal weight
What does Brachycephaly do the the BPD? correct answersIt Falsely widened BPD , can lead to
overestimation of the EFW.
What organ is affected that will severely mess with the Abdominal Circumference (AC)? correct
answersThe fetal liver is the one which will highly alter the circumference of the fetal abdomen
What does Torch infections cause? correct answersOrganomegaly with enlargement of the liver
or spleen and the resulting increase in the abdominal circumference in the presence of fetal
IUGR
How do you get the most Reliable estimated fetal weight(EFW) ? correct answersFormulas
incorporated with multiple fetal parameters such as BPD HC AC and FL
How do your know that a Estimated Fetal Weight (EFW) is IUGR? correct answersWhen the
EFW is below the 10th percentile
What do you do on each Zone of EFW? correct answersZone 1- the EFW is abobe the lower
%20 confidence limit and IUGR is ruled out
Zone 2- The EFW is between zone 1 and 3, which has a 24% prevalence of IUGR, patients in
this zone should have serial sonograms and fetal heart monitoring.
Sonography(100% Correct answers)
What will birth weight help with figuring out? correct answersif its small for gestational age
SGA or large for gestational age LGA
What is intrauterine growth restriction (UGR) or fetal growth restriction (FGR). correct answersa
decresed rate of fetal growth
What are IUGR babies in greater risk of? correct answersAntepartum death, perinatal asphyxia
( body deprived of oxygen cause unconsciousness or death), Neonatala morbidity, and later
developmental problems.
What are the most significant maternal factors for IUGR? correct answersHistory of a previous
fetus with IUGR, significant maternal hypertension or smoking, The presence of a uterine
anomaly (bicornuate uterus or large leiomyoma) and significant placental hemorrhage.
What is the difference of IUGR and SGA? correct answersSGA is the fetus with a weight below
the 10th percentile without reference to the cause. Fetal growth restriction is a subset of the SGA
fetuses with a weight below the 10th percentile as a result of pathological processes resulting
from a variety of maternal, fetal aor placental disorders.
THE SGA fetus may be normal but constitutionally small, but a fetus with IUGR is ill and does
not follow a normal growth trajectory. The fetal. Size lagging farther and farther behind the
expected growth rate.
What is the difference between Symmetric and asymmetric IUGR? correct answersSymmetric
IUGR is usually the result of a first-trimester insult, such as a chromosomal abnormality or
infection, Fetus is usually proportionately small throughout pregnancy.
Asymmetric IUGR generally begins in the second or third trimester and usually results from
placental insufficiency, This fetus usually shows head sparing at the expense of abdominal and
soft tissue growth .
What could cause Symmetric growth restriction? correct answersLow genetic growth potentia,
intrauterine infection, severe maternal malnutrition, fetal alcohol syndrome, chromosomal
anomaly, or severe congenital anomaly
What could cause Asymmetric growth restriction? correct answersCould be the result of
maternal disease, such as diabetes (classes D-F), Chronic hypertension, cardiac or renal disease,
abruptio placentae, multiple pregnancy, smoking, poor weigh gain, drug use, or uterine anomaly.
Still all normal non high risk mother could still be born with it. All pregnancies undergoing
sonographic examinations should be evaluated for IUGR
What does Asymmetric IUGR measurement have different? correct answersIt will have the
appropriate BPD and HD but disproportionately small AC , this reinforces the BRAIN-
SPARING effect.
, What is Brain Sparing effect? correct answersThe body tries to keep the brain alive and give as
much nutrients to it, depriving the body of it to be able to keep it alive.
Multiple parameters for intrauterine growth restriction IUGR correct answersBPD. Imaged in the
transverse plane using the cavum septi pellucidi, thalamic nuclei, falx cerebri, and choroid plexus
as landmarks. The BPD can be misleading in cases associated with unusual head shapes. Used
alone, it is a poor indicator of IUGR.
HC to AC ratio. High false-positive rate for use in screening
general population. The HC to AC ratio is useful in determining the type of IUGR.
FL to AC ratio. Not dependent on knowing gestational age. The FL to AC ratio has a poor
positive predictive value.
FL. May decrease in size with symmetric IUGR.
AC. Measure at level of portal-umbilical venous complex. When
growth is compromised, AC is affected secondary to reduced adipose tissue and depletion of
glycogen storage in liver. AC is the single most sensitive indicator of IUGR.
What does Dolichocephaly do to the BPD? correct answersIt falsely shortened BPD, can lead to
underestimation of the fetal weight
What does Brachycephaly do the the BPD? correct answersIt Falsely widened BPD , can lead to
overestimation of the EFW.
What organ is affected that will severely mess with the Abdominal Circumference (AC)? correct
answersThe fetal liver is the one which will highly alter the circumference of the fetal abdomen
What does Torch infections cause? correct answersOrganomegaly with enlargement of the liver
or spleen and the resulting increase in the abdominal circumference in the presence of fetal
IUGR
How do you get the most Reliable estimated fetal weight(EFW) ? correct answersFormulas
incorporated with multiple fetal parameters such as BPD HC AC and FL
How do your know that a Estimated Fetal Weight (EFW) is IUGR? correct answersWhen the
EFW is below the 10th percentile
What do you do on each Zone of EFW? correct answersZone 1- the EFW is abobe the lower
%20 confidence limit and IUGR is ruled out
Zone 2- The EFW is between zone 1 and 3, which has a 24% prevalence of IUGR, patients in
this zone should have serial sonograms and fetal heart monitoring.
