20.    The picture shows a term baby.                              

a)        What is the likely diagnosis?

           IUGR.

b)         What are the factors affecting fetal growth?

            1.    Fetal: constitutional, chromosomal and genetic defects, intrauterine infection in the 1st trimester.

             2.    Maternal: maternal nutrition, PIH, GDM, nicotinc, alcohol.

             3.    Placental problems.

c)         What are the problems this infant is likely to face? 

            1.    Asphyxia. 

             2.    Hypoglycaemia.

             3.    Hypothermia.

             4.    Hyperbilirubinaemia.

d)         How can this condition be prevented during pregnancy?

            1.    Immunizations. 

             2.    Use of low dose aspirin in PE.

             3.    Elective LSCS to deliver the baby.

             4.    Early detection of IUGR and constant monitoring.

             5.    Resuscitation at delivery.