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Intrauterine Growth Restriction IUGR PowerPoint Presentation

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Description : Check out this medical titled "Intrauterine Growth Restriction IUGR”.

This medical is about intrauterine growth restriction (IUGR), a condition where a fetus fails to grow at a normal rate inside the uterus during pregnancy. This can occur due to a variety of reasons, such as maternal malnutrition, chronic maternal illness, smoking during pregnancy, maternal substance abuse, placental abnormalities, or fetal genetic abnormalities.

IUGR can lead to serious health consequences for the fetus, such as low birth weight, premature birth, and a higher risk of perinatal morbidity and mortality. Additionally, infants who experienced IUGR may be at a higher risk of long-term health problems, such as cognitive and developmental delays, cardiovascular disease, and type 2 diabetes.

Treatment for IUGR depends on the underlying cause and the severity of the condition. Some interventions that may be considered include close monitoring of fetal well-being, maternal nutrition support, medications to improve blood flow to the uterus, or early delivery if the risks of continuing the pregnancy outweigh the risks of premature birth.

Tags : Intrauterine Growth Restriction, IUGR, uterus during pregnancy, maternal malnutrition, chronic maternal illness, smoking during pregnancy, maternal substance abuse, placental abnormalities, fetal genetic abnormalities, Neonatal-Perinatal Medicine, Neonatal-Perinatal Medicine

Published on : Jun 01, 2023 | Views : 1565 | Downloads : 0

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Slide 1-

Intrauterine Growth RestrictionIUGR
Slide 2-

Normal Intrauterine Growth
Slide 3-

Symmetric - Stage I growth inhibition Fewer cells but normal size - weight, head, length all < 10th percentile Perinatal problems? Higher Lower Growth potential? Higher Lower
Slide 4-

Asymmetric - Stage II/III growth inhibition Decrease in cell size, less effect on total cell number - weight below 10th percentile,head and length preserved Perinatal problems? Higher Lower Growth potential? Higher Lower
Slide 5-

What factors affect fetal weight? Sex term males 150 gm heavier and 0.9 cm longer than females Parity 1st born infants smaller effect loss after 3rd birth Race, ethnicity, nationality Altitude Denver population growth curves under estimate weights of infants born at sea level Maternal size maternal pre-pregnancy weight and pregnancy weight gain correlate with fetus size
Slide 6-

“Maternal constraint”- non-genetic Number of fetuses Reduced rate of fetal growth of multiples Small breed embryo transplanted into large breed uterus will grow larger
Slide 7-

Hormonal Factors Insulin Major hormone for in utero growth Produced by fetus Promotes fetal adipose deposition, glycogen stores
Slide 8-

Etiology- Overlapping Maternal factors Medical disease (US) Malnutrition (world-wide) Multiple pregnancy Drugs Hypoxemia Small stature/ low pre-pregnancy weight Teen pregnancy Low SES Prima gravida Grand multiparity Maternal, Fetal, Placenta
Slide 9-

Fetal Genetic Congenital malformations Genetic/ chromosomal (trisomies, syndromes) Cardiovascular disease Congenital infection Inborn errors of metabolism
Slide 10-

Placenta placental insufficiency post dates anatomic abnormal insertion hemangiomas infarcts abruption
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Diagnosis Algorithm IUGR yes TORCH stigmata  work-up? no yes Dysmorphic features  work-up? no
Slide 12-

Case # 3 Infant is delivered at 38 weeks to mom who presents with headaches and epigastric pain BW: 2.1 kg HC: 50th%tile Lt: 30th%tile Pre-eclampsia/ HELLP
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Case # 3- What if? Mom with no prenatal care delivers undiagnosed twins at EGA 34 weeks Discordant twins
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Case # 3- What if? An infant is delivered at 42 weeks via c- section due to NRHTs after induction Post dates - decreased subcutaneous fat - skin desquamation - wizened facies - large AF(diminished membranous bone formation) - meconium staining
Slide 15-

Diagnosis Algorithm IUGR yes TORCH stigmata  work-up? no yes Dysmorphic features  work-up? no yes Maternal/placental explanation work-up? no
Slide 16-

Case # 3- What if? Infant delivered at EGA 34 weeks to mom with no prenatal care and positive tox screen
Slide 17-

Diagnosis Algorithm IUGR yes TORCH stigmata  work-up? no yes Dysmorphic features  work-up? no yes Maternal/placental explanation work-up? no yes Maternal drug use tox screen no Unknown cause
Slide 18-

True or False IUGR infants are prone to asphyxia True Why or why not? Perinatal hypoxia Chronic and acute Increased C/S rate, decreased Apgar, increased resuscitation need
Slide 19-

An IUGR infant is at risk for Hypothermia? Hypoglycemia? Or Hypocalcemia? decreased subcutaneous fat, increased surface- volume ratio, decreased heat production decreased glycogen stores/ glycogenolysis/ gluconeogenesis increased metabolic rate deficient catecholamine release Associated with perinatal stress, asphyxia, prematurity
Slide 20-

Which lab result(s) would not be associated with IUGR? WBC 4, S8 & B1 H & H 11/ 33 Plt 65 PT 16 PTT 56 Direct bilirubin 4.5 Neutropenia Polycythemia Elevated erythropoietin Thrombocytopenia Elevated coags TORCH
Slide 21-

Which CxR is more consistent with IUGR? Increased meconium aspiration Decreased surfactant deficiency
Slide 22-

Perinatal problems Perinatal asphyxia Hypothermia Hypoglycemia Hypocalcemia Polycythemia, hyperviscosity Thrombocytopenia Neutropenia Elevated coags Decreased surfactant deficiency Increased meconium aspiration syndrome Direct hyperbilirubinemia
Slide 23-

Evaluation and Management Physical exam Labs - blood sugar - urine shell vial (CMV) - calcium - viral cultures (HSV) - CBC diff/plt - syphilis w/u - bilirubin - tox screen - head ultrasound - chromosomes - total IgM vs specific
Slide 24-

Quick algorithm
Slide 25-

Evaluation and Management Monitor postnatal weight gain/ head growth needs may exceed 100-120 cal/kg/d catch- up by 6-12 months Hypersomatotropism- accelerated growth velocity ? Safety of aggressive feeding rapid weight gain may predispose to childhood obesity highest risk for developing type 2 DM
Slide 26-

IUGR- Outcome Neurodevelopment etiology and adverse event dependent lower intelligence, learning/ behavioral disorders, neurologic handicaps symmetric, chromosomal disorders, congenital infections--- poorer outcome school performance influenced by social class
Slide 27-

World’s smallest…..