Physiologic Complications for the Appropriate Gestational Age Baby

Infants whose weight is < the 10th percentile for gestational historic period are classified as pocket-sized for gestational age. Complications include perinatal asphyxia, meconium aspiration, polycythemia, and hypoglycemia.

Fenton growth chart for preterm boys

Fenton T, Kim J: A systematic review and meta-assay to revise the Fenton growth nautical chart for preterm infants. BMC Pediatrics 13:59, 2013. doi: ten.1186/1471-2431-13-59; used with permission. Available at world wide web.biomedcentral.com.

Fenton growth chart for preterm girls

Fenton T, Kim J: A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatrics 13:59, 2013. doi: 10.1186/1471-2431-xiii-59; used with permission. Available at www.biomedcentral.com.

Causes may exist divided into those in which the growth brake is

• Symmetric: Superlative, weight, and head circumference are about equally affected.

• Asymmetric: Weight is near affected, with a relative sparing of growth of the brain, attic, and long bones.

Symmetric growth restriction usually results from a fetal problem that begins early in gestation, often during the 1st trimester. When the crusade begins relatively early in gestation, the unabridged body is affected, resulting in fewer cells of all types. Common causes include

• Genetic disorders

• Showtime-trimester built infections (eg, with cytomegalovirus Built and Perinatal Cytomegalovirus Infection (CMV) Cytomegalovirus infection may be acquired prenatally or perinatally and is the nigh common congenital viral infection. Signs at birth, if nowadays, are intrauterine growth restriction, prematurity... read more , rubella virus Congenital Rubella Congenital rubella is a viral infection acquired from the mother during pregnancy. Signs are multiple congenital anomalies that can event in fetal death. Diagnosis is by serology and viral... read more , or Toxoplasma gondii Congenital Toxoplasmosis Congenital toxoplasmosis is acquired past transplacental conquering of Toxoplasma gondii. Manifestations, if present, are prematurity, intrauterine growth brake, jaundice, hepatosplenomegaly... read more )

Asymmetric growth brake ordinarily results from placental or maternal issues that typically manifest in the late 2nd or the 3rd trimester. When the cause begins relatively late in gestation, organs and tissues are not equally affected, resulting in asymmetric growth restriction. Mutual causes include

• Placental insufficiency resulting from maternal affliction involving the small blood vessels (eg, preeclampsia Preeclampsia and Eclampsia Preeclampsia is new-onset or worsening of existing hypertension with proteinuria after 20 weeks gestation. Eclampsia is unexplained generalized seizures in patients with preeclampsia. Diagnosis... read more , hypertension Hypertension in Pregnancy Recommendations regarding classification, diagnosis, and management of hypertensive disorders (including preeclampsia) are available from the American College of Obstetricians and Gynecologists... read more than , renal disease Renal Insufficiency in Pregnancy Pregnancy oft does not worsen renal disorders; it seems to exacerbate noninfectious renal disorders but when uncontrolled hypertension coexists. However, significant renal insufficiency ... read more , antiphospholipid antibody syndrome Antiphospholipid Antibody Syndrome (APS) Antiphospholipid antibiotic syndrome is an autoimmune disorder in which patients have autoantibodies to phospholipid-bound proteins. Venous or arterial thrombi may occur. The pathophysiology is... read more than , long-standing diabetes Diabetes Mellitus in Pregnancy Pregnancy aggravates preexisting type 1 (insulin-dependent) and type 2 (non–insulin-dependent) diabetes but does not announced to exacerbate diabetic retinopathy, nephropathy, or neuropathy (one)... read more )

• Placental involution accompanying postmaturity

• Maternal malnutrition

Symptoms and Signs of SGA Infant

Despite their size, SGA infants have physical characteristics (eg, skin appearance, ear cartilage, sole creases) and behavior (eg, alertness, spontaneous activity, zest for feeding) similar to those of normal-sized infants of like gestational historic period. Yet, they may announced thin with decreased musculus mass and subcutaneous fat tissue. Facial features may appear sunken, resembling those of an elderly person ("wizened facies"). The umbilical cord can appear thin and pocket-size.

Complications

Full-term SGA infants do non have the complications related to organ organization immaturity that premature infants of similar size have. They are, however, at take chances of

• Perinatal asphyxia

• Meconium aspiration

Hypoglycemia oft occurs in the early hours and days of life because of a lack of adequate glycogen synthesis and thus decreased glycogen stores and must be treated quickly with Iv glucose.

Polycythemia may occur when SGA fetuses experience chronic mild hypoxia caused by placental insufficiency. Erythropoietin release is increased, leading to an increased rate of erythrocyte production. The neonate with polycythemia at birth appears cherry-red and may exist tachypneic or lethargic.

Hypothermia may occur because of impaired thermoregulation, which involves multiple factors including increased rut loss due to the decrease in subcutaneous fat, decreased heat production due to intrauterine stress and depletion of nutrient stores, and increased surface to volume ratio due to small-scale size. SGA infants should be in a thermoneutral surroundings to minimize oxygen consumption.

If asphyxia tin exist avoided, neurologic prognosis for term SGA infants is quite skilful. However, afterwards in life there is probably increased run a risk of ischemic heart disease, hypertension, and stroke, which are thought to be caused by abnormal vascular development.

Infants who are SGA considering of genetic factors, congenital infection, or maternal drug utilise ofttimes have a worse prognosis, depending on the specific diagnosis. If intrauterine growth restriction is acquired by chronic placental insufficiency, adequate nutrition may allow SGA infants to demonstrate remarkable "catch-upwardly" growth after delivery.

• Supportive care

Underlying conditions and complications are treated. In that location is no specific intervention for the SGA state, but prevention is aided past prenatal advice on the importance of fugitive booze, tobacco, and illicit drugs.

• Infants whose weight is < the 10th percentile for gestational historic period are small for gestational age (SGA).

• Disorders early on in gestation cause symmetric growth restriction, in which height, weight, and head circumference are about equally affected.

• Disorders belatedly in gestation cause asymmetric growth restriction, in which weight is virtually afflicted, with relatively normal growth of the brain, attic, and long bones.

• Although small, SGA infants do not take the complications related to organ organization immaturity that premature infants of like size have.

• Complications are mainly those of the underlying crusade but generally also include perinatal asphyxia, meconium aspiration, hypoglycemia, polycythemia, and hypothermia.

ruddgasselve.blogspot.com

Source: https://www.msdmanuals.com/professional/pediatrics/perinatal-problems/small-for-gestational-age-sga-infant

Share this post