Small for Gestational Age

(SGA)

<Presentations>

<Index>

 

Definition

-  EFW &/or AC <10 centile for specific gestation on US

 

Features

-  Increased risk of stillbirth, birth hypoxia, neonatal complications

-  Increased risk of developing DM2 & HTN as an adult

 

Causes

-  Genetically small 50-70%

-  IUGR

 

DDx

-  IUGR: persistently <10 centile over time +/- evidence of malnutrition &/or chornic hypoxia

 

Ix

-  US

 

Mx

-  If normal morphology scan (ie: no congenital anomalies) & normal umbilical artery Doppler likely genetically small & not IUGR

-  Labour

-  Continous CTG in labour

-  Delay IOL until 37/40 if end diastolic flow present & other findings NAD

-  Absent or reversed flow

-  Admission

-  If biophysical profile or dopplers abnormal then IOL

-  Daily CTG +/- biophysical profile

-  If abnormal CTG then IOL

 

 

 

References

 

-  RCOG Guideline 31: Investigations & Management of the Small for Gestational Age Fetus, Nov 2002

RCH Neonatal Handbook: SGA infants