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Iugr & Iufd د.اسماء
Iugr & Iufd د.اسماء
•Infections
•Multiple gestation
maternal medical conditions result in IUGR?
•HPT
•Preeclampsia
•DM with vascular involvement
•SLE
•Anemia
•Sickle cell disease
•Antiphospholipid syndrome
•Renal disease
•Malnutrition
•Inflammatory bowel disease
•Intestinal parasites
•Cyanotic pulmonary disease
?How does the placenta play a role in the development of IUGR
Congenital infections:
•CMV
•Rubella
•Herpes
•Vericella zoster
•Toxoplasmosis
•Malaria
•Listeriosis
drugs can result in IUGR:
•Alcohol
•Cigarette smoking 3-4X
•Heroin & coccaine
•Methotrexate
•Anticonvulsants
•Warfarin
•Antihypertensives /ß-blockers
•Cyclosporin
genetic disorders that can result in IUGR:
U/S-3
•Fetal biometry for dating then serial measurements
•Anomaly scan
•AF index
•Doppler umbilical artery resistance index, MCA
•Repeat tests every1-2 wks
Invasive fetal testing-4
•Amniocentesis or placental biopsy/ fetal blood sampling
for karyotyping if aneuploidy is suspected
for viral studies if infections suspected
•Caries the risks of infection, PROM, Preterm labor
Retrospective tests-5
Diagnosis
Absence of uterine growth
Serial ß-hcg
Loss of fetal movement
Absence of fetal heart
Disappearance of the signs & symptoms of pregnancy
X-ray Spalding sign
Robert’s sign
U/S 100% accurate Dx
Causes OF IUFD
•A traumetic event
•Post-partum depression
•Anxiety
•Psychotherapy
•Recurrence 0-8% depending on the cause of IUFD