This document discusses small for gestational age (SGA) babies, including the definition, implications, causes, diagnosis, and management. SGA refers to babies that fail to reach weight thresholds by certain gestational ages. Left undetected and unmonitored, SGA can lead to stillbirth, birth complications, and long-term health issues. Common causes include chromosomal abnormalities. Diagnosis involves ultrasound scans, fundal height measurements, and Doppler tests. Management includes determining causes, surveillance with Doppler ultrasound, and deciding on delivery timing and method based on test results.

1. Small for gestational age Dr.V.Ravimohan SpR

6. Ott Wj.The diagnosis of altered fetal growth.Obstet Gynecol Clin North Am 1988;15:237-63

7. 50.6–83.8% 72.9–94.5% High risk ultrasound scan biometry(AC) 48% General customised fundal chart 88% 27% General SFH specificity sensitivity population

12. Causes of Growth restriction High risk pregnancy management options 2nd edition p300

13. Chromosomal abnormalities

15. Doppler indices Systolic-end diastolic peak velocity Mean systolic velocity Pulsatility index Systolic-end diastolic peak velocity systolic peak velocity Resistance index Systolic peak velocity diastolic peak velocity S/D ratio

16. Doppler Absent/Reverse EDF EDF present Delay delivey till 37w* >34 weeks deliver <34 weeks (i)Admission (ii)Closed surveillance (iii)steroids

20. Survival by birth weight

21. Survival by gestation

23. 588 babies (fetal compromise between 24-36 weeks) Immediate delivery (296) Delivery when obstetrician no longer uncertain (292)

24. OR 1.1(0.7-1.8)