Dismaturity

Dismaturul is the child whose birth weight is less than 2 standard deviations (SD) gestational age corresponding to the weight. About 30% of all babies are premature.
Dismaturitatea (SGA-Small for gestational age) or fetal hypotrophy is determined in fetal growth retardation (IUGR, intrauterine fetal growt Retardation).Immediate neonatal morbidity in fetal growth retardation induced is characterized by: hypoxia, respiratory failure caused by aspiration, hypoglycemia, hypocalcemia, thrombocytopenia, malformations, infections.
Etiology:
When detected causes dismaturitatii classify them into four categories: maternal, placental, fetal and environmental.
Maternal factors have a percentage of 25-30% of all aetiological factors. In the same category are found: hipostenic constitutional type, reduced overweight during pregnancy, high blood pressure (hypertension) associated with pregnancy, diabetic vasculopathy, chronic nephropathies.
Placental factors include: placenta praevia, circumvallata (transfer function is impaired even in the absence of bleeding), placental insufficiency in prolonged pregnancy, abnormal cord insertion (marginal mental sail), single umbilical artery.
Fetal factors include the following: chromosomal abnormalities (Turner syndrome, trisomy 13, 18, 21), intrauterine infections (herpes, cytomegalovirus, rubella, toxoplasma, listeria, Treponema, tuberculosis, hepatitis), congenital malformations, multiple pregnancy (induced decrease in placental weight relation to fetal weight).
Environmental factors may be: severe maternal malnutrition with inadequate protein intake and glucose, smoking acts by reducing uterine blood flow, alcoholism, drug use (cocaine, phenytoin).
Diagnosis
In principle, the diagnosis can be established prenatally by ultrasound.Umbilical artery Doppler Velocimetria help assess placental blood flow and uteroplacental insufficiency diagnosed.Amniocentesis performed at 10-14 weeks of pregnancy allows the diagnosis of genetic diseases and to determine fetal karyotype.DNA analysis allows the diagnosis of alpha-thalassemia, Duchenne and Becker muscular dystrophy, cystic fibrosis.Chorionic Biposia argument focused on genetic diagnosis.
Most dismaturilor are born by Caesarean section. Birth vaginally is recommended in cases favorable: the multipara, aged cervix, absence of other contraindications.
Dismaturii will be evaluated postnatally by weight index quantifying the weight deficit, it is by reporting the percentage of weight to height. In these children should be instituted as early oral aorta, and if the infant is severely depressed by the use of parenteral nutrition. To get a good growth rate in these children have increased caloric intake.Glucose and serum calcium should be monitored at short intervals (6-10 hours).Dismaturii growth rate may be unsatisfactory or mental disabilities to remain with a very high degree. Frequently associates an impaired development of children who have nervous system birth weight less than 1700 g.