MCQp1a36

a.	infection of the fetus	True
b.	hypertensive disorders of pregnancy	True
c.	diabetes	True
d.	multiple pregnancy	True
e.	premature labour	False
f.	cigarette smoking	True
g.	chromosomal abnormality	True
h.	raised serum AFP at 16 weeks followed by normal 18 week scan	True
i.	polyhydramnios	False
j.	neonatal hyperglycaemia	False
k.	respiratory distress syndrome	False
l.	low socio-economic status	True

IUGR is inversely related to social class.

Infection, chromosomal and other abnormalities e.g. Potter's syndrome cause IUGR.

Diabetes is associated with macrosomia, but also IUGR.

Multiple pregnancy is often associated with IUGR, hence the routine practice of scanning all multiple pregnancies fortnightly from 28 or 30 weeks.

Premature labour produces low birthweight babies, but not IUGR.

The things to remember about fags is that they cause IUGR, but are associated with a reduced risk of hypertensive disease.

A raised AFP with an apparently normal baby (see question 1 above) is associated with:

a high incidence of IUGR,

a high incidence of premature labour,

a high incidence of fetal death in utero.

IUGR and oligohydramnios go hand in hand.

The 'small for dates' baby has low glycogen stores and is at risk of hypoglycaemia.

They need regular 'Dextrostix' monitoring and early feeding.

They are at reduced risk of respiratory distress syndrome and generally put on weight rapidly so long as there is no underlying problem.