Pregnancy
Early pregnancy assessment：
It is advised to have the first assessment at 6-8 weeks of pregnancy. A detailed history and physical examination will be performed. Ultrasound will be done to assess the location of the pregnancy, the number of fetuses and the viability. The expected date of delivery should also be confirmed. For pregnant women who experience spotting, bleeding or abdominal cramps, it is advised to seek medical advice as soon as possible to exclude pregnancy complications, e.g. miscarriage or ectopic pregnancy.
NIPT：
NIPT stands for non-invasive prenatal testing. It is a screening test determining the risk that the fetus will be born with certain chromosomal abnormalities, including Down syndrome (trisomy 21), Edwards syndrome (trisomy 18) and Patau syndrome (trisomy 13). The accuracy of detecting the trisomies is over 99%. NIPT can also detect other rare chromosomal abnormalities, including extra or missing copies of the sex chromosomes, and deleted or duplicated sections of a chromosome. When compared to the traditional screening methods, it is more informative and reliable. NIPT can be done as early as 10 weeks of pregnancy. A small sample of blood is taken from the mother for the test, and thus it poses no risk to the fetus. It is important to note that the NIPT is a screening test only. If the result is positive, a confirmatory test, either chorionic villi sampling or amniocentesis, is needed to confirm the result.
Antenatal check-up：
It is important to have regular antenatal check-ups to ensure the health of the pregnant women and the fetus. The following are the important check-ups during the whole pregnancy journey.
| weeks |
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| 18-22 weeks |
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| 24-28 weeks |
- Fasting blood glucose level or |
| 26-34 weeks |
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| 35-37 weeks |
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Here is the recommended schedule of the antenatal visits:
- Before 28 weeks: once every 4 weeks
- 28-36 weeks: once every 2 weeks
- After 36 weeks: once a week
Delivery:
One of the biggest decisions women need to face during pregnancy is the mode of delivery. They can either have a vaginal birth or caesarean section. For some pregnant women, caesarean section is a better mode of delivery, e.g. in cases of malpresentation of the fetus, low-lying placenta, or maternal conditions like pre-eclampsia. In most cases, pregnant women can choose their preferred mode of delivery. No matter how the baby is delivered, the main goal is the safety of the mother and the baby. Therefore, it is important for pregnant women to discuss with their obstetricians the pros and cons of each option and choose the one most suitable for them.
| Vaginal delivery | Caesarean section |
Pros | - Natural way of delivery. - Shorter hospital stay and faster recovery. - Earlier skin-to-skin contact with the baby with better initiation of breastfeeding. - By passing through the birth canal, the baby will be less likely to have breathing problems. | - Scheduled delivery. - It avoids labour pain and prolonged labour. |
Cons | - Unable to predict the time of delivery. - Labour pain. - Risks of vaginal tears. - Higher risks of birth trauma. - Potential need for caesarean section. | - Long hospital stay. - Surgical risks – bleeding, infection, injury to surrounding organs. - Risks to subsequent pregnancies – placenta problems like placenta previa/accreta, presence of adhesions which increases the risks of future operations.
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Postnatal care
Postnatal care is the medical and emotional care provided to a woman after childbirth. This care is important to help the woman recover physically and emotionally from the stresses of pregnancy and childbirth, and to help ensure the health and well-being of both the mother and baby.
Here are some aspects of postpartum care that may be included:
- Physical recovery: The woman's healthcare provider will monitor her physical recovery after childbirth, including checking for any signs of infection, monitoring blood pressure, and checking for any complications related to the delivery.
- Breastfeeding support: If the woman chooses to breastfeed, her healthcare provider can provide guidance and support to help her establish and maintain a successful breastfeeding routine.
- Emotional support: Childbirth can be a challenging and emotional experience, and postpartum care may include counselling or support to help the woman cope with any emotional or psychological issues that may arise.
- Contraception: The woman's healthcare provider can provide guidance on contraception options, including those that are safe to use while breastfeeding.
- Follow-up appointments: The woman may have several follow-up appointments with her healthcare provider in the weeks and months after childbirth to monitor her recovery and address any concerns that may arise.
- Newborn care: The woman's healthcare provider may provide guidance on newborn care, including feeding, sleeping, and other aspects of infant care.
It is important for women to receive appropriate postpartum care to ensure a safe and healthy recovery, and to establish a strong foundation for the health and well-being of both the mother and baby. Women should discuss any concerns or questions they may have with their healthcare provider and should seek medical attention if they experience any symptoms or complications after childbirth.
