IUGR - India’s Premier Educational Institution JK.pdf · • uterine artery • normal flow •...
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Transcript of IUGR - India’s Premier Educational Institution JK.pdf · • uterine artery • normal flow •...
![Page 1: IUGR - India’s Premier Educational Institution JK.pdf · • uterine artery • normal flow • function • trophoblastic invasion • early detection of • preeclampsia pi/uterine](https://reader031.fdocuments.us/reader031/viewer/2022022409/5cc2442388c993c70a8d95ad/html5/thumbnails/1.jpg)
IUGR
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• Defenition
• SGA
• Cause
• Placental insufficiency
• UA
• MCA
• FETAL CVS
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• S/D=PSV/EDV
• RI= PSV‐EDV/PSV
• PI=PSV‐EDV/MEAN
• VASCULAE IMPEDANCE/VASCULAR RESISTANCE
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• UTERINE ARTERY
• NORMAL FLOW
• FUNCTION
• TROPHOBLASTIC INVASION
• EARLY DETECTION OF
• PREECLAMPSIA PI/UTERINE NOTCHING 2ND
TRIMESTER
• IUGR‐‐‐RI
• UNCLEAR MESSAGES
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UMBLICAL ARTERY
• AREAS
• END DIASTOLIC FLOW
• FETAL BREATHING
• DIASTOLIC VELOCITY
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MCA
• BRAIN SPARING EFFECT = PI
• LOW ,HIGH
• PSV =IUGR
• ANEMIA,HYPOXIA ‐‐‐‐PATHOPHYSIOLOGY
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MEASUREMENT OF MCA/PSV
• AXIAL SECTION ‐‐‐SPHENOID BONE
• CIRCLE OF WILLIS‐‐‐‐ANGLE 0
• ENLARGE MCA
• INTERROGATE MCA
• MEASURE PSV
• REPEAT 3‐5 TIMES
• REPEATED WAVEFORMS SHOULD BE SIMILAR
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• LOW MCA PI• Brain growth post uterine contractions
• Heart rate
• Severe anemia
• Post transfusion
• Therapeutic amniocentesis
• Hypoximia/acidemia
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HIGH MCA PI
• UTERINE CONTRACTION
• HEART RATE
• OLIGOHYDRAMNOIS
• FETAL HEAD COMPRESSION
• SUSTAINED HYPOXEMIA /ACIDEMIA
• HYDRANENCEPHALY
• INDOMETHACIN ADMINISTRATION
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• DESCENDING AORTA
• SPLENIC ARTERY
• SMA
• ADRENAL ARTERY
• RENAL ARTERY
• SUPERIOR CEREBELLAR ARTERY
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FETAL VENOUS SYSTEM
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FETAL CARDIAC SYSTEMATRIO/VENTRICULAR VALVES
• E=• A=• NORMAL=A>E• MID= A=E• LATE= A<E• IUGR E/A
• MR/TR
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AORTIC/PULMONARY VALVES
• PEAK VELOCITY ‐‐‐
• IUGR—
• PLACENTAL RESISTANCE
• RT‐‐‐‐LT VENTRICLE SHIFT
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• NST/UA –NORMAL=NO FETAL ACIDOSIS /HYPOXIA=STAGE 1
• NST‐‐‐NOR , UA‐‐‐ABNORMAL‐‐‐5% HYPOXIA/= STAGE 2
• BOTH ABNORMAL =50% HYPOXIA=STAGE 3
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• STAGE 1
• Abnormal UA PI
• Abnormal MCA PI
• STAGE 2
• UA—ABSENT
• MCA PSV‐‐‐
• DV PI abnormal
• Umblical vein pulsation
• STAGE 3
• DV PI ‐‐‐‐REVERSE
• UV—REVERSED FLOW
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