Uterine Size < Dates



Uterine Size < Dates


Roya Sohaey, MD



DIFFERENTIAL DIAGNOSIS


Common



  • Intrauterine Growth Restriction (IUGR)


  • Oligohydramnios


Less Common



  • Fetal Demise


ESSENTIAL INFORMATION


Key Differential Diagnosis Issues



  • Fundal height (FH) vs. menstrual age (MA)



    • FH = clinical measurement from pubic symphysis to top of uterus


    • FH in cm = MA in wks


    • FH is most accurate at 18-32 wks


    • Ultrasound more accurate than FH


Helpful Clues for Common Diagnoses



  • Intrauterine Growth Restriction (IUGR)



    • Estimated fetal weight < 10th percentile


    • Causes



      • Placental insufficiency


      • Anomalous fetus


      • Intrauterine infection


    • Doppler assessment



      • ↑ Umbilical artery resistance


      • ↑ Uterine artery resistance


      • ↑ Ductus venosus resistance


      • ↓ Middle cerebral artery resistance


    • Associated with oligohydramnios


  • Oligohydramnios



    • Fetal causes



      • Bilateral renal agenesis


      • Bilateral renal anomaly


      • Bladder outlet obstruction


    • Non-fetal causes



      • Placental insufficiency


      • Post-term pregnancy (> 42 wks)


      • Premature rupture of membranes


      • Maternal dehydration


    • Idiopathic not common


Helpful Clues for Less Common Diagnoses

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Aug 10, 2016 | Posted by in OBSTETRICS | Comments Off on Uterine Size < Dates

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