We are updating our policies for Term SGA in our unit.

I wonder if you routinely perform head and/or renal US scan in such babies and if you investigate for CMV.

 

With best regards

 

Marcello De Filippo

II level Neonatology Unit

Grosseto, Italy

This a great topic, we all see theses babies often and yet I have come across many different approaches

What we usually do:

1. if babies are asymmetrically growth retarded and especially if there is a history of maternal illness (like preeclampsia): we usually do nothing BUT consider nutrition as a catch.up-growth can be expected

2a. if the baby is symmetrically growth retarded and more than -3 SD from the expected BW - we usually do TORCH titers on the mother, urinary CMV on the infant, and head ultrasound to look for calcifications

2b. if these tests are all normal and the baby looks well besides being small, we generally follow-up growth and development for these being < -3SD in our policlinic (until 24 months of age)

2c. if the baby have stigmata or being unwell, we usually do a "syndrome" evaluation, including charyotype / micro-array, possible echocardiography and renal ultrasound, and an eye investigation

Would be great to hear from more members about their approaches.

Dear Dr Johansson,

Many thanks for your replay. I think it's the most logical (and CLINICAL) approach. I don't think that "bombing" every 2.700 grams newborn by ultrasound is a good practice (and I'm an echographist). I would be glad to receive more protocols of others units.....I'll try to ask beyond the ocean.

 

Marcello De Filippo

NICU, Grosseto Italy

Hi Marcello,

If an infant is below 10th % we routinely test for CMV & less routinely investigate for TORCH.

Only occasionally ultrasound.

We would always enhance nutrition.

Regards, Gayle