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Obstetrics and gynaecology
Published in David A Lisle, Imaging for Students, 2012
Macrosomia refers to a fetus with EFW above the 90th centile for gestational age or EFW >4500 g. Macrosomia associated with maternal diabetes carries an increased risk of fetal demise. Macrosomia may also be associated with birth trauma. Management of placental insufficiency and other factors that may impact on fetal well-being is assisted by assessment of various US parameters including: Amniotic fluid volumeDoppler analysis of umbilical artery, umbilical vein, ductus venosus and fetal middle cerebral arteryFetal breathing movementsFetal limb movementsFetal heart rate.
Reproductive system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Fetal weight estimation can be calculated from the HC, AC and FL measurements, also contributing to the management of delivery. In some cases growth may be above that expected (macrosomia), which also needs monitoring, as delivery of a large baby can lead to complications such as shoulder dystocia.
Modern dietary guidelines for healthy pregnancy; maximising maternal and foetal outcomes and limiting excessive gestational weight gain
Published in European Journal of Sport Science, 2019
Kirsty Jayne Elliott-Sale, Ashley Graham, Stephanie Jane Hanley, Sherry Blumenthal, Craig Sale
With 38% of the world’s female population classified as obese (Ng et al., 2014), it is vital that the impact of obesity on maternal and foetal health is considered. Conception, pregnancy, labour and delivery, including surgery, are more difficult for obese women, therefore, helping these women to achieve a healthier, prenatal, weight should be part of our practice. Obesity during pregnancy can increase the risk of adverse health outcomes for both mother and baby. Studies show an increased risk of preeclampsia, gestational diabetes and hypertensive disorder in obese pregnant women, as well as increased incidence of macrosomia (Dutton et al., 2018). Pre-gravid obesity can also impair foetal monitoring, leading to the need for specialised equipment, issues with anaesthesia and a greater likelihood of miscarriage (Weindling, 2003). Maternal obesity is also linked with a host of long term adverse health outcomes, such as postpartum weight retention, an unlikeness to breastfeed and childhood obesity (Fraser et al., 2011; Nehring, Schmoll, Beyerlein, Hauner, & Von Kries, 2011; Vesco et al., 2009). Recent data have also show an association between higher maternal BMI in late pregnancy and an increased risk of cardiovascular disease, type 2 diabetes and cancer in offspring (Eriksson, Sandboge, Salonen, Kajantie, & Osmond, 2014). As such, maternal obesity must be considered as a healthcare priority, due to its numerous and far-reaching effects. Moreover, the economic burden of maternal obesity must be considered as the associated costs of maternal overweight, gestational diabetes mellitus and macrosomia are substantial (Lenoir-Wijnkoop, van der Beek, Garssen, Nuijten, & Uauy, 2015).