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The Complete Pregnancy FAQ from A-Z

The Complete Pregnancy FAQ from A-Z

Frequently Asked Questions (FAQ) in Pregnancy

Contents

This article is a compilation of most frequently asked questions for pregnant women compiled by our author who are experts in O&G. Over 1500 answers & tips are provided to help educate and engage the women in Singapore.

Quick Answers

  1. To contact a doctor for medical advice, click here for the Directory of pregnancy Medical Providers in Singapore
  2. Ask questions and up vote on the quality of the answers in the popular pregnancy Q&A section
  3. For a list of recommended shopping, click here for the recommended pregnancy shopping list
  4. For a list of recommended lifestyle,  click here for exercise, cooking and other lifestyle options

What is a Pregnancy FAQ definition ?

The top questions that are commonly asked by pregnant women about their condition.

How to get getting pregnant ?

Should I go for preconception checkup? What preconception tests should I have?

  • It is a good idea to go for a preconception checkup for both the future mum and dad!
  • This allows early detection of any medical conditions that may hinder fertility or cause problems in the pregnancy, and an opportunity for a doctor to answer all your pregnancy-related questions!
  • Providing your medical history to the physician is an important part of your preconception check up. You and your partner’s health condition, lifestyle, your periods (i.e. how regular they are) will give the doctor the basis for his or her recommendation regarding conception and pregnancy.
  • The doctor will do a complete physical exam for you, including a pelvic exam and speculum exam to have a general look at the health of your reproductive tract. Your doctor may also suggest a pap smear if you haven’t had one done in the past two years, or perform a vaginal swab if you have any symptoms such as itch or abnormal discharge.
  • Being pregnant can make any known or unknown iron-deficiency anemia worse; a recent blood test allows the doctor to show you whether you need to take iron supplements.
  • Sexually transmitted infections are often asymptomatic, but they can be passed to your baby through the reproductive tract. Checking for STIs (including HIV) before or during pregnancy is compulsory in some areas.
  • Hepatitis can be passed on from mother to fetus, and can cause chronic liver disease. You may test for presence of this virus in your book, as well as your immunity to the virus due to childhood vaccination. If your test results show that you are not immune to hepatitis B (either because you did not get vaccinated as a child, or your immunity waned over the years), you may receive vaccination before your conception to provide protection for you as well as your baby.
  • Rubella, and chickenpox are all virus that could cause serious infections in the fetus. In order to provide the best protection for your baby in case of exposure during pregnancy, we recommend testing your immunity for them prior to conception, and getting vaccinated if needed.
  • Your doctor may recommend certain special genetic tests for you and your partner if your history reveals certain conditions that run in the family (e.g. cystic fibrosis). These tests allow both you and your doctor to be prepared for possible complications, and provide the most suitable management plan and follow-up.

I am on contraception and now I want to conceive; how do I stop it?

  • If you are using natural methods (e.g. withdraw, avoidance of ovulation period) of barrier method (condom, diaphragm), all you have to do is stop using them. Rest assured that recent use of spermicide does not harm the pregnancy.
  • If you are using a contraceptive pill, your fertility should theoretically resume as soon as you stop taking it. You may stop taking your contraceptive pill at any time, however you may complete the month if you would like to keep to your menstrual cycles (bleeding will occur within days of stopping the pill). For some women, ovulation may be delayed, and it may take a few months before conception is possible. Please speak to your doctor if you have any concerns about this.
  • The depo-provera shot provides effective contraception for 12 weeks following your injection. While it is not possible to reverse this within the 12 week period, some women are successful at conceiving soon after the 12th week. However, this is large dependent on the individual, and some women taken up to 1-2 years after the last injection to conceive. Please see your practitioner if you have trouble conceiving more than 1 year since your last injection.
  • The Implanon implantable device should end its contraceptive effects as soon as it is removed. Please visit a doctor for safe removal of the device.
  • If you are currently using an intrauterine device, you may try for pregnancy as soon as it is removed. Your fertility should return right away. Please visit a doctor for safe removal of the device.
  • Surgical sterilization is considered a permanent contraceptive method. However, reversal is possible in some cases, with variable level of success. Please visit a OBGYN specialist to discuss your options. Be sure to ask about the process and risks for future pregnancies (e.g. increased ectopic pregnancy).

How do I increase fertility?

  • Generally, we would advise any couple that fails to conceive after 1 year of trying to seek medical attention. However, women above 35 years old may choose to seek fertility consultation earlier (e.g. after 6 months of trying) to increase the chance of getting pregnant. If you have been trying less than one year, here are some tips. Remember, having regular intercourse (at least 3 times a week) is still the most important factor to conceiving a pregnancy.
  • Predicting the timing of ovulation is an important strategy to increase chances of getting pregnant. This means matching the timing of intercourse to your time of ovulation (releasing the egg). There are several methods to predicting your ovulation.
  • Experts believe that the “missionary position” affords the best opportunity for conception. This position allows for the deepest penetration and places the sperm closest to the cervix. Other effective alternatives include rear entry and side entry.
  • Ladies may try elevating your hips with a pillow if in a lying position, so that the cervix is exposed to the maximum amount of sperm. You may also try to stay in bed for about 30 minutes after intercourse, to prevent gravity from undoing your work!
  • Ladies will experience a slight increase in body temperature just after ovulation. Measure your body temperature every morning after waking up, and keep a record. After a few cycles, a pattern should emerge.
  • Cervical mucus is noted to be thinner and clearer during ovulation. Another indication is mild lower tummy pain or light spotting, which occurs when the egg is released from the follicle in the ovary.
  • Over the counter test kits are available which test your urine, and tells you whether you are ovulating according to the change in colour.

What could be the cause of sub fertility?

  • To find out the reason causing your subfertility, you will need to visit a doctor to have a series of specialized tests.
  • Female factors include anovulation (failure of the ovaries to produce eggs), fallopian tube blockage, womb/cervical mucus defects, and endometriosis. Please visit a fertility specialist, who will be able to guide you to the most appropriate investigations and treatment.
  • Male infertility factors include abnormal sperm amount, motility, or shape. Please visit a fertility specialist, who will be able to guide you to the most appropriate investigations and treatment.
  • Mixed factors mean that there are more than one problem involving both the male and female partners.
  • Please visit a fertility specialist, who will be able to guide you to the most appropriate investigations and treatment.

Am I pregnant ?

What are the common pregnancy symptoms ?

  • Many women experience nausea, vomiting and bloatedness. Some feel breast tenderness, while other experience constipation. These are temporary symptoms and will disappear in second trimester as your body adjusts to the new pregnancy.
  • Hang in there!

Have you taken a pregnancy test?

  • You may purchase a pregnancy kit from a local pharmacy; otherwise, you can also visit a doctor to take a pregnancy test.
  • You may confirm the pregnancy by visiting a clinic, where you will get a referral to see an Obstetrician, or visit a private Obstetrician to begin your pregnancy journey.
  • You may consider testing again in a few days’ time, as it may be too early for the hormone levels to rise to a detectable range.
  • Usually, two red lines indicates a positive test, where as one red line indicates a negative test. Do read the package instructions carefully, as individual brands may vary.

How do Ovulation kits work ?

  • Ovulation Predictor Kit is the most common type of fertility check on the market. It works by detecting the level of luteinizing hormone, a hormonal surge event that indicates ovulation, where the egg breaks out of its storage place inside the ovary and begins its journey into the womb. Depending on the brand, it will pinpoint your most fertile 2-4 days in the cycle, which will be indicated by a positive test. The representation of a positive test also depends on the brand used. It might take the form of lines or symbols such as smiley face. Make sure to read the packaging carefully!
  • The fertility monitor is also a urine test, using test sticks in combination with a monitoring machine. Instead of testing around the estimated date of ovulation, you will need to test your urine every day from day one of your period. It also detects the luteinizing hormone surge (LH surge) that occurs prior to ovulation. The benefit is that instead of a “yes/no” answer in the ovulation prediction kit, you will be given information on whether fertility status (low, high, or peak) on a daily basis so you plan your intercourse with more information. The downside is that it is a more expensive and time-consuming process.
  • A less common type of fertility testing is the saliva test. This detects the estrogen level in your body (which occurs before the LH surge and before ovulation). It is easy to use, however is often difficult to interpret (requires looking at the microscopic pattern of the sample to determine results).

Common concerns during Pregnancy

Watch the How to have a healthy pregnancy below

I am pregnant and feeling very tired, what can I do ?

  • It is common to feel tired and unable to keep up with your usual routines in early pregnancy. Once the placenta is formed (around the 4th month), which takes a lot of energy to accomplish, and your body has adjusted to the hormonal and emotional changes pregnancy brings, you may feel an improvement in yout fatigue.
  • Keep in mind that fatigue is a signal from your body that you need to take it easier. Get the rest your body needs!
  • If you feel like you are feeling unusually sad, anxious, or unable to cope, please bring this up to your obstetrician during your next appointment.
  • He/she will be able to assess you better, and refer you to the most appropriate source for support.

My bowel movements have been unusual, what can I do?

  • Constipation during pregnancy is a common complaint. Your intestinal movements slows down due to the hormonal changes that are occurring in your body. You may try to keeping hydrated, taking in more fiber and probiotics such as yogurt, as well as take smaller and more frequent meals.
  • You may also check with your doctor to see if any of your existing medications may contribute to the constipation.
  • Diarrhea during the pregnancy is not normal, and could be due to viral or bacterial infections. To avoid dehydration, we would like to suggest visiting a doctor to assess your hydration and determine if there is any infection.
  • Bloody stools are especially dangerous, and warrants immediate visit to a doctor.
  • Being gassy during the pregnancy is very common. You may try taking smaller and more frequent meals, eating slowly, and. While it may be troubling for you, rest assured that it is not a problem for your baby.

Is it common for pregnant women to have nose bleed?

  • Nose bleeding is in fact a common symptom in pregnancy.
  • This is because the hormonal changes in a pregnant women’s body, especially increase in estrogen and progesterone, increases blood flow and mucus membrane.
  • This results in a stuffy nose and nosebleed from easily breakable new capillaries. Sit comfortably and press on the bridge of your nose. The bleeding should stop within a few minutes. Do not lean back, may case aspiration.

Why is there a dark line running down my tummy?

  • Pregnancy hormones caused the hyperpigmentation, or darkening, of the skin.
  • One location that is particularly noticeable is running from your umbilicus to the pubic region, and this is called renamed the linea nigra, or black line.
  • It usually starts to appear during the second trimester and most often will begin to fade a few months after delivery (but for some women it may never go away entirely – it’s a line of honour!). Don’t worry, all expecting mums will have it and it’s completely normal!

I have had abortions in the past; will this affect my baby?

  • First trimester abortions usually have little effect on subsequent pregnancies.
  • However, this still depends on each individual’s anatomy,
  • Mid-trimester abortions (MTPT) that occurred after the first trimester may have some effect on subsequent pregnancies. For example, studies have shown a slightly increased risk of preterm labor.
  • Please do let your doctor know about your full medical history, so he or she can give you the most optimized care.

Watch the Video on 6 common pregnancy symptoms in the 1st Trimester below

This is my second (third/fourth) pregnancy; how will it different from my first?

  • You may experience physical symptoms of pregnancy earlier this time around (e.g. baby movements), mainly because you are now familiar with how they feel and can pick them up earlier.
  • However, you may not experience the same symptoms (e.g. severity of vomiting) as the first pregnancy, as all babies are unique! Your baby bump may look different, too.
  • You may experience slightly more bothersome backache, as your abdominal muscles may not be as strong as in the first pregnancy after multiple births.
  • Some mothers report feeling less excited about the pregnancy after the first birth. Don’t fret, this is normal and common, as you now have other children to care for who will take up a significant amount of your attention. However, if you experience overwhelmingly low mood, please do see your doctor to talk about your symptoms.
  • If you had a vaginal birth before, it is likely that you will experience a quicker and easier labor and delivery this time around. Your perineal muscles and cervix are now familiar with relaxing to allow the baby to exit, which accounts for the shorter birth process.
  • If you have had 1 c-section before, you may discuss with your physician to see if you are a safe candidate for VBAC (vaginal birth after caesarian) if you would like to opt for natural birth. it will be similar to a first-time mother trying vaginal birth.

Can I breastfeed during the pregnancy?

  • If you are concerned about changes in the breastmilk as you enter another pregnancy, don’t worry!
  • Studies show that the quality of the breastmilk remains safe and largely unchanged during pregnancy, and pregnancy hormones generally do not pass into the breastmilk.
  • It is a common concern that breastfeeding may lead to early womb contractions through the hormone, oxytocin. However, during the majority of a normal, uncomplicated pregnancy, breastfeeding only brings on mild womb contractions that does not harm the baby. However, when the pregnancy approaches term (37 weeks), oxytocin does start to take effect on the womb, so it would be advisable to pause breastfeeding when you approach term.
  • Milk supply may slow down in the middle of the pregnancy. However, this varies from individual to individual. If your supply is adequate, it is totally feasible to breastfeed both your older and newborn at the same time.

How much weight gain is normal in the pregnancy?

Your ideal weight gain during pregnancy is based on your pre-pregnancy BMI.

Below is a range of normal weight gain

  • < 18.5 is between 12 to 18kg
  • 18,5 to 25 is between 11 to 16kg
  • 25 to 30 is between 7 to 11kg
  • > 30 is between 5 to 9kg

Watch the Top Top 6 pregnancy symptoms in 2nd and 3rd Trimester

I am overweight; will this affect my baby?

  • Most overweight mums deliver perfectly healthy babies.
  • However, overweight mums do have an increased risk of complications compared to normal weight mums.
  • Mums who are above normal weight have increased risk of the following complications: gestational diabetes, hypertension of pregnancy, miscarriages, preterm labor, stillbirth and certain types of birth defects.
  • It may be more difficult to estimate the baby’s size and anatomical features in mums who are overweight. Both normal delivery and caesarian sections may be more difficult and longer in duration for overweight mums as well.
  • You can minimize your risk by staying within the recommended weight range (try asking the bot, “what is my appropriate weight gain?”), and working closely with your doctor to monitor any potential complications. Also, as always, try to eliminate all other habits that are bad for your pregnancy, such as drinking and smoking.

I am underweight; will this affect my baby?

  • Most underweight mums deliver healthy babies.
  • However, underweight mums do face increased risk of some pregnancy complications compared to normal weight mums.
  • Underweight mums are at risk of having a baby who is small-for-gestational-age, as well as preterm birth.
  • Your risk can be minimized by eating well, taking your vitamins, and gaining weight according to the recommend weight range.

I am an older mum; how does this affect my baby?

  • Usually, women over 35 years are considered as “advanced maternal age” (AMA).
  • Women below 35 years old are generally considered to have low-risk for age-related genetic diseases, such as Down syndrome. For example, the risk of Down Syndrome is 1 in 1250 in a 25 year old mum, 1 in 1000 in a 30 year old mum, but jumps to 1 in 300 for 35 year old mums and 1 in 35 in 45 year old mums.
  • Nevertheless, Down Syndrome screening is now universally recommended to all age groups, because even younger mums still have a small risk of having a baby with Down Syndrome.
  • The good news is, most older mums still give birth to healthy babies! However, as your age increases, the likelihood of having a baby with genetic syndromes, such as Down Syndrome, increases. For example, the risk of Down Syndrome is 1 in 1250 in a 25 year old mum, 1 in 1000 in a 30 year old mum, but jumps to 1 in 300 for 35 year old mums and 1 in 35 in 45 year old mums.
  • We would strongly recommend getting a screening test in the first trimester to determine your baby’s risk, if you think this will change your plans for the pregnancy. Other risks include higher chance of miscarriage, preeclampsia, diabetes, and conceiving twins. There is also a higher rate of c-sections among older mums.

My partner is an older dad; will this affect my baby?

  • The older the partner’s spermatocytes, the longer they have to undergo mutations or be exposed to environmental harm.
  • For example, the risk of having a miscarriage increases as the dad’s age increases. Nevertheless, the effect of dad’s age on pregnancy is very small in this age group.
  • In addition to increased risk of miscarriage for dads in this age group, some studies have shown a small increase in the risk of autism in fathers older than 40.
  • In addition to increased risk of miscarriage and autism, the incidence of Down syndrome increases in fathers over 50 years old. Nevertheless, the risk is very small.
  • Please speak to your doctor if you would like to undergo Down Syndrome screening for your baby.

I am a scatterbrain or very forgetful in pregnancy – is this normal?

  • Many moms-to-be begin to feel this way!
  • Some report suddenly find themselves forgetting appointments, missing meetings, and losing their train of thought.
  • Researchers have found that a woman’s brain-cell volume actually decreases during pregnancy. Fortunately, this pregnancy brain fog is only temporary. Most women get back to their normal level of sharpness a few months after delivery.
  • As for the cause, like most pregnancy symptoms, pregnancy forgetfulness is hormonally triggered. Sleep deprivation can also play a role.
  • Here are some methods to try! But do keep in mind that you may need to get used to working at a little below peak efficiency. The fog may well continue after your baby’s arrival (because of fatigue, not hormones) and perhaps may not lift completely until baby (and you) start sleeping through the night.
  • Relax
  • Feeling stressed about this intellectual fogginess will only make it worse (stress also compounds forgetfulness). Recognizing that it is normal (and not imagined), even accepting it with a sense of humor, may help to ease it—or, at least, make you feel better about it. Realistically, it might just not be possible to be as efficient as you were before you took on the added job of baby making.
  • Checklists
  • Keeping checklists on your smartphone (along with reminder alarms) can help contain the mental chaos—that is, if you can remember where you put your phone last. Set electronic reminders of important dates and appointments, and tap into the What to Expect app.
  • Post it Notes
  • Strategically placed post-its (one on the front door to remind you to take your keys, for instance) can also help keep you on track.
  • Protein and Complex Carbohydrates
  • You may find more focus from incorporating protein and complex carbohydrates. Low blood sugar caused skipping meals can definitely contribute to that foggy feeling.
  • Don’t take Gingko Biloba
  • Although ginkgo biloba has been touted for its memory-boosting properties, it’s not considered safe for use during pregnancy. We would advice staying away from any herbal preparation which are advertised in this manner, as they are adequately rarely tested for safety.

Can I get vaccinations in the pregnancy?

  • Many viruses can make you very sick during the pregnancy, so being vaccinated is important.
  • However, it is best to get all the vaccines you need before conception, as some vaccines are not recommended in the pregnancy.
  • Specifically, vaccines that use live viruses should not be taken during the pregnancy, such as MMR (measles, mumps, and rubella) and varicella (chicken pox).
  • Other immunizations, such as hepatitis B, are safe. In fact, the seasonal flu vaccine and the Tdap vacine (diphtheria, tetanus, and pertusis) are recommended for every pregnant women.
  • Please visit your doctor and get them done at the recommended timing!

Should I go for thalassemia testing?

  • If you and your partner have a history of thalassemia
  • If both you and your partner have a family or personal history of thalassemia. In this case, we strongly recommend you to go for prenatal diagnostic testing to find out whether your unborn baby has thalassemia major, a life-threatening condition. Based on the result of these tests, your doctor will be able to advise you accordingly.
  • If only you have a family or personal history of thalassemia, and your partner does not. In this case, it is not likely that you will require thalassemia testing.
  • If its only you, that has a family or personal history of thalassemia, and your partner is unsure of his status. In this case, we would strongly advise your partner to undergo a simple blood test to test for thalassemia. Your doctor will be able to advise you accordingly when both your results are available.
  • If you do not but your partner has a history of thalassemia
  • If only your partner has a family or personal history of thalassemia, and you do not. In this case, In this case, it is not likely that you will require thalassemia testing. However, your doctor will monitor you for anemia during the pregnancy. In case anemia is found and not well explained, your doctor might discuss testing for thalassemia again at the suitable point.
  • If neither you nor your partner has a family or personal history of thalassemia
  • If neither you nor your partner have a family or personal history of thalassemia. In this case, it is not likely that you will require thalassemia testing. However, your doctor will monitor you for anemia during the pregnancy. In case anemia is found and not well explained, your doctor might discuss testing for thalassemia again at the suitable point.
  • If both of you have not been tested for thalassemia
  • From what you’ve told me, neither you or your partners have been tested for thalassemia. In this case, your doctor may start withdrawing your blood for a simple test for your red blood cell count. If it is normal, then your baby will likely be okay. If you are found to have low blood count, you will be advised to go under further testing, and your partner will need to have his blood tested as well.

Should I go for diabetes/sugar testing?

  • This will depend on the specific practice of your country, hospital, as well as your risk factors.
  • For example, some hospitals in Singapore has implemented universal screening for gestational diabetes (GDM), where as others are only screening those at high risk (e.g. >35 years old; obese; family history of DM).
  • Please check with your doctor to clarify the practices in your area, and your unique medical history.

What is considered Normal Results ?

  • The normal fasting glucose level should be <5.5mmol/L
  • The normal 2-hour glucose tolerance level should be <8.4 mmol/L

When should I tell my family that I am pregnant?

  • When to tell your family is totally up to you. Some couples opt to hold off on any announcements until the first trimester has passed, and some keep the secret as long as they can—say, until the baby bum- starts making it obvious. Others have rushed off to tell the world. Still others tell selectively, starting with those closest. Since there’s no right or wrong time to tell or way to tell, do whatever works for you.
  • Understandable, just about every couple worries about the “what-if.” What if the happy news turns to sad news—what if pregnancy ends soon after it has started, with a miscarriage? More than any other reason, that’s why many couples hold off on announcing pregnancy until the first trimester is safely behind them.
  • But here’s the flip side to keeping pregnancy completely to yourselves early on. Should the unlikely event of a miscarriage or undesirable result on prenatal testing, will going it alone make the sad news harder to handle? So talk it over with your partner, and do what feels most comfortable. Just remember: In spreading the good news, don’t forget to take the time to savor it as a twosome.”

When should I tell my workplace that I am pregnant?

  • When to break to news to your workplace is your judgement call.
  • We may suggest that you can think about these following factors: environmental risk of your workplace (radiation, assess the risk), upcoming reviews, and baby-friend-level of your workplace!

When can I found out if my baby is a boy or a girl?

  • Usually, the sex of the baby can be determined at 20 weeks, during the fetal abnormalities scan.
  • If you are doing a special bloodtest called NIPT (non-invasive prenatal test), you will be able to find out as early as 12 weeks.
  • The radiographer will usually ask you whether or not you would like to find out at this time. It is completely up to you whether you want to find out at this point, or leave it as a surprise!

What can i expect at each antenatal checkup?

  • Generally, at each antenatal checkup, the doctor will ask you about your recent symptoms, examine your abdomen, measure your new weight, and answer any questions you may have at each particular stage of pregnancy.
  • Special ultrasound scans will be done at certain timepoints in the pregnancy, such as a fetal abnormalities scan at 20 weeks.
  • As you progress in the pregnancy, ultrasound scans to check the position and size of your baby will become more frequent.

What pregnancy scans should I do?

  • Here is a list of the types of scans that are offered and recommended in each pregnancy.
  • About the Dating Scan
  • The dating scan is usually done around 8-10 weeks after your last menstrual period (i.e. 4-6 weeks after your missed period). It is used to confirm the place of the fetus inside the womb and the presence of a heartbeat, which indicates viability. The size of the fetus is measured and used to estimate the current gestational age of the baby, as well as your estimated date of delivery. This scan will also be able to tell you if you’re having one baby or more than one. How exciting!
  • About the OSCAR test
  • The OSCAR test, recommended around 12 weeks, is used to screen for fetal trisomies – an abnormality of the genetic composition of the baby. The risk of your baby having trisomy is calculated based on an algorithm, taking into consideration measurements of the fetal neck, nose bone, and maternal age. In the case of a high-risk result (greater than 1 in 100 chance), further testing is necessary to confirm the diagnosis.
  • About the Fetal Abnormalities test
  • The Fetal Abnormalities scan is recommended at 20 weeks gestational. This is an important ultrasound scan that takes a detailed look at all the major organs of the baby and whether they are developing normally. This includes four chambers of the heart, the brain, the limbs, and the abdominal organs. Usually, this is also the time to find out the gender of the baby, if you wish to do so!
  • About Growth Scans
  • Growth scans are ultrasounds done routinely starting in the third trimester. Their main purpose is to check the position of the placenta and position of the baby (head up or down) in order to plan the delivery. Additionally, the fetal weight is estimated by taking the abdominal circumference of the fetus on the scan.

Are ultrasound scans safe in the pregnancy?

  • Yes! Ultrasound scans are commonly used by doctors for pregnant mums because they are safe and simple to use for obtaining images of your baby and his/her surrounding environment. They do not emit radiation, but rather sound waves that turn into a live, moving black-and-white image. Would you like to learn about different types of ultrasound scans?
  • About Abdominal Ultrasound
  • This most common form of ultrasound uses a small, rectangular probe to look at the baby through scanning your lower abdomen. It is usually not painful and very safe.
  • About Transvaginal Ultrasound
  • The transvaginal ultrasound involves inserting a thin probe into your vaginal with a disposable cover. This is sometimes necessary because when the fetus is in the early stages, the abdominal ultrasound may not be able to detect it or make out its details due to its small size. The vaginal pathway provides a much closer look to the womb. It method may cause slight discomfort in some women, but rest assured that it is safe for the baby.
  • About Doppler Ultrasound
  • Doppler ultrasound is a more specialized mode to look at blood flow through the placenta and the health status of the baby. Only certain pregnancies at higher risk may require this scan, and it uses a higher dose of soundwave compared to other types of ultrasound. Nevertheless, it is still within safe limits.

What medications should I avoid?

  • This question does not have a straight forward answer, as depend on many factors, including your stage of pregnancy and the risk benefit balance of taking or not taking the medication in your unique situation.
  • We would advice you to speak to your doctor about taking any medication in the pregnancy, so he or she can ensure that you are taking only what is necessary for you.
  • Don’t stop or start taking any type of medication that you need without first talking with a healthcare provider. Don’t make decisions about medication use during pregnancy based on lists you find online. Instead use the lists as a starting point to talk with your doctor.

Should I have a pap smear during pregnancy?

  • If you had your pap smear done < 3 years ago
  • You are not yet due for your next Pap smear. Women between 21 and 65 are recommended to screen every 3 years (unless you have had abnormal results in the past), so you may plan ahead and let your doctor know when you would like to screen next. Your postnatal appointments may be a good time for this, as a pelvic exam is usually done.
  • If you had your pap smear done > 3 years ago or not at all
  • Based on the information you provided, you are due for your next Pap smear! Antenatal appointments (and postnatal appointments) are good opportunities to do them, since doctors may need to examine you anyways so you can avoid an additional less-than-comfortable examination. Do discuss with your doctor at your next appointment!

Is bleeding normal in pregnancy?

  • Bleeding in the first trimester is concerning for a number of conditions, including miscarriage, threatened miscarriage, and ectopic pregnancy.
  • These conditions range widely in seriousness (e.g. mild implantation spotting in the first few weeks of pregnancy is common and harmless, where as an ectopic pregnancy could be life threatening).
  • If the bleeding is heavy (more than spotting) and associated with any abdominal pain, please seek emergency medical help. If you are having painless spotting, let your doctor know on the next visit, or consider visiting a nearby doctor’s office as early as possible.
  • Bleeding in the second trimester can be due to fetal, placental, or maternal conditions.
  • We recommend visiting an emergency room. Bleeding in the third trimester is concerning for placenta abnormalities such as placenta previa (low-lying placenta) or placenta abruptio (painful condition where placenta tears from uterine wall). Both these conditions may cause harm to the baby, please visit the emergency room immediately.

Can I take x-rays during the pregnancy?

  • Routine x-rays (such as dental x-ray) should be postponed until after delivery, just to be on the extra-safe side.
  • But if putting off x-rays during pregnancy just isn’t a good idea (the risk of having one is outweighed by the risk of not having one), most practitioners will green-light the procedure. That’s because the risks of x-rays during pregnancy are really very low and can be easily made even lower. Dental x-rays target your mouth. In addition, your doctor will put a lead shield to protect your baby. What’s more, a typical diagnostic x-ray of any kind rarely delivers more radiation than you’d get from spending a few days in the sun at the beach. Harm to a fetus occurs only at very high doses, doses you’re extremely unlikely to ever be exposed to. Still, if you do need an x-ray during pregnancy, keep the following rules in mind.”
  • Always inform the doctor or dentist ordering the x-ray and the technician performing it that you’re pregnant, even if you’re pretty sure they know and even if you checked it off on any forms you filled out.
  • Have any necessary x-ray done in a licensed facility with well-trained technicians.
  • The x-ray equipment should, when possible, be directed so that only the minimum area necessary is exposed to radiation. A lead apron will be used to shield your womb, and a thyroid collar should protect your neck.

Can i eat or drink during labour ?

  • Hospitals and doctors have different policies on eating and drinking during labour.
  • Eating during labour provides you with extra nourishment and energy to push during delivery.
  • If you do eat during labour, choose something light and easy on the stomach, that gives you an energy boost (such as toast or plain biscuits).
  • If you are thirsty and can drink during labour, isotonic drinks are recommended to give you energy. However, some may not recommend eating or drinking during labour, especially if you are on pain relief medication (as these can slow down movement of food through your stomach), or if you may need a general anesthetic (for an emergency caesarean section).
  • Don’t worry, if you are restricted on food and drinks during labour, you will still be able to suck on ice chips which will refresh you and cool you down during the tiring process of labour.

Baby Is Born

Is it safe to vaccinate my baby?

  • It is natural to be concerned about whether immunizations are safe, especially if your precious baby is having his or her first set of injection. Vaccination (or immunization) is a powerful defense that is safe, proven, effective, and protects your baby from serious childhood diseases.
  • Some countries have national childhood immunization schedules that parents can follow, and some vaccinations are mandatory by law. Nearly every child can be vaccinated, except those with allergies to something in the vaccine, or those with a weakened immune system. Like other medications, they can occasionally cause reactions.
  • Most of these are mild, such as a sore arm or mild fever. Serious reactions are rare but can occasionally happen. Remember that getting the disease is generally much more serious than the side-effects of the vaccine. If you have further questions about the risks and benefits of vaccinations, talk to your doctor to find out more.

What about Sex during and after pregnancy ?

Being pregnant doesn’t have to mean the end of intimacy. However, many couples have concerns that sexual intercourse may harm the pregnancy in some way. We address some of the common concerns to put your mind at rest. Many expectant mothers find that their sexual desires change during different stages of pregnancy. It has been noted that coital frequency is reduced in 60%, remains same in 30% and increases in 4% of couples.

Most find that they’re not in the mood for sex in first trimester when they are struggling with morning sickness. Things may improve in the second trimester when their enjoyment is heightened by hormone rise and they’re more responsive to touch. In the third trimester, however, fatigue, expanding baby bump and concern over impending labour are likely to cause a dip in sexual desire again.

Is sex safe during pregnancy ? Watch the video below to learn more ?

What sex positions are safe in pregnancy?

  • This is a very common question from pregnant couples.
  • For vaginal sex, most positions are safe, as long as your partner does not put any weight on your belly. After the 2nd trimester, it is also a good idea not to lie flat on your back for an extended period of time. Most pregnant women’s may find that side-lying positions are most comfortable as they keep you off your back. You can try front-front facing side positions or front-back facing side positions (i.e. spooning). Rear-entry positions placing you on your knees are also safe.
  • Oral sex is safe and a great way to stay intimate throughout the pregnancy. The only point to note is that make sure your partner does not blow air directly into the vagina, which can sometimes cause problems in your uterine blood vessel (air emboli).

Is masturbation safe in pregnancy?

  • Masturbating during pregnancy is perfectly safe and a great way to release all the tension felt during pregnancy.
  • However, in some rare pregnancy conditions such as history of preterm labor, orgasms are off-limits because they can cause womb contractions. In these cases, it is wise to refrain from sex and masturbation.

How soon can I resume sex after giving birth?

  • Just gone through the amazing experience of childbirth, but not feeling ready for intimacy yet? This is very common in the postpartum period, as the exhaustion from labour and delivery has taken a huge toll on your body, putting sex at the back of your mind. Wondering when it is safe to have sex after giving birth? How did you deliver your baby?
  • Naturally, your vagina will be sore from stretching to allow your baby to pass through the birth canal, and will be even more tender if you’ve had an episiotomy and stitches in place. You may also have lochia (the discharge of leftover blood, tissue and mucus). Many couples wait until 6 weeks after delivery before having sex again. Sexual intercourse may be painful initially and use of a lubricant may be helpful. But remember, every pregnancy and every woman’s body is different, thus there is no set time where you should aim to have sex. In the meantime, foster closeness with your partner in other ways, such as cuddling, kissing, or simply spending time together (and with your baby). Also, do Kegel exercises (clenching your pelvic muscles) to help your vagina feel firmer! On the contrary, if you feel ready to be close with your partner again, get the green light from your doctor first, as having sex soon after pregnancy may increase your risk of infections or affect the healing of the vaginal tears.
  • Your body has just gone through major surgery and you may be having pain from the healing incision. Many couples wait until 6 weeks after delivery before having sex again. Sexual intercourse may be painful initially and use of a lubricant may be helpful. But remember, every pregnancy and every woman’s body is different, thus there is no set time where you should aim to have sex. In the meantime, foster closeness with your partner in other ways, such as cuddling, kissing, or simply spending time together (and with your baby). On the contrary, if you feel ready to be close with your partner again, get the green light from your doctor first, as having sex soon after pregnancy may increase your risk of infections or affect the healing of the incision.

I am pregnant and feeling depressed, what can I do?

  • How many of these symptoms you have had in the past two weeks:
  1. sadness/crying,
  2. poor appetite,
  3. insomnia,
  4. lack of concentration,
  5. lack of energy,
  6. feeling guilty,
  7. lack of interest in the activities you usually enjoy.
  • If you have none of these problems
  • Alright, no problem! Depressive symptoms affect as many as 1 in 4 women in early pregnancy, and it is a problem that obstetricians take very seriously! Please speak to your doctor at your next appointment so they can offer the most appropriate support. In the mean time, here are some resources that you can read up on, which may help with your mood. Remember you are never alone, and your doctors are happy to support you. If you feel that you have thoughts of harming yourself, please get in touch with a doctor immediately.
  • If you have 0 to 4 of these symptoms
  • Depressive symptoms affect as many as 1 in 4 women in early pregnancy, but it may not constitute true depression. Here are some tips on how to keep emotionally well in the pregnancy. If you continue to experience these symptoms or would like additional support, please speak to your doctor at your next appointment so they can refer you to the most appropriate help. If you feel unable to cope or have feelings of harming yourself at any point in time, please get in touch with a doctor immediately.
  • If you have 5 to 7 of these symptoms
  • It appears that your symptoms are quite extensive, and your emotional health is something that we take very seriously. We would like to advice you to make an early appointment with your obstetrician, so he/she can provide the most appropriate support!

I am feeling very stressed / anxious in the pregnancy, what should I do?

  • It is very common for expecting mums to feel are stressed during their 9 months. Let us know which of these describes you better, so we can offer the most appropriate help.
  • Research shows that pregnancy isn’t affected by typical stress levels. If you feel that you are able to cope well with your everyday stress, then your baby will be able to cope just fine, too. Here are some advice that may help you manage your stress better!
  • Stress that isn’t well managed can take its toll, particularly if it continues into the second and third trimesters. In addition to the tips offered here, we would advice you to join a support group or see a mental health specialist to help you along your journey.
  • “If dealing with your current state of pregnancy gets too overwhelming for you, establishing a routine will help you feel better in control of your life. Try working your activities and schedule so that you will be meaningfully engaged. Also, do allow flexibility to changes in your schedule, as you will need much rest. If dealing with your current state of pregnancy gets too overwhelming for you, establishing a routine will help you feel better in control of your life. Try working your activities and schedule so that you will be meaningfully engaged. Also, do allow flexibility to changes in your schedule, as you will need much rest.
  • Taking care of yourself means allowing you to have time for yourself to rest or to do little things that you enjoy. It will do you a world of good to be out of the house for a breather or fresh air, even for a short period of time. You may even want to go window-shopping or to catch up with a friend, if you are allowed to walk about.
  • Taking care of yourself also means taking care of what you eat, so that you have the right nutrition needed to carry your baby. Light exercise would help build up your immune system and prepare you with the energy needed for your pregnancy and childbirth. Please consult your obstetrician for advice if you are not sure what is appropriate for you.
  • Talking to your partner or friend, a doctor or counselor about your thoughts and feelings is also a great way of releasing your pent-up emotions. You should be able to get your emotional support from your partner, but someone with symptoms of depression or anxiety should benefit from seeking advice and treatment from a specialist.
  • Another way to keep your days going is to write your thoughts and feelings down in a diary. Having a baby is a life-changing and significant time for you. Writing down your thoughts could help you to keep track and gain a better perspective of what happened and how things have affected you.
  • Coping with pregnancy can be an enormous stress for many people. Do not be embarrassed about getting the help that you need, may it be with household chores or caring for family members. You would need to rest and converse your energy for your health.

How do I look after my health and what kind of diet while pregnant ?

What should I eat or drink during the pregnancy?

  • You may be glad to know that the dietary restrictions in pregnancy is a very short list.
  • The only advice is to avoid raw food (including runny eggs and soft cheese), as they may carry microorganisms that could cause infection, harmful for you and your baby. Besides this, you can feel free to have any nutritious, balanced diet of your choice!

Should I eat for two?

  • Great question! In fact, that is a myth. Eating twice as much doesn’t double your chances of having a healthy baby – instead, it’s likely to mean excessive weight gain for you, which can put you at risk for pregnancy complications. This is because your body becomes more efficient at absorb nutrients during pregnancy.
  • Research evidence suggest that says if you’re at a healthy weight, you need no additional calories in the first trimester. Starting the second trimester, where the baby is growing faster in size, you may need around 340 extra calories a day, and around 450 extra calories a day in the third trimester. If you’re overweight or underweight, you’ll need more or less than this depending on your weight gain goal.
  • These numbers would also be different if you’re having twins or more! Check with your doctor if you need any clarifications.

What supplements should I take?

  • Most of us can get the vitamins we need by eating a balanced diet. However, there are certain vitamins that we would recommend depending on your period of pregnancy.
  • In the 1st Trimester
  • The only supplement that is needed in early pregnancy is folic acid. In fact, we recommend you to start taking folic acid as soon as you are trying to conceive. Please check with your doctor regarding the dosage, which depends on several factors, including your past medical and obstetrics history.
  • In the 2nd Trimester or 3rd Trimester
  • As the baby grows larger, it requires a little more nutrient from you. We would recommend you to start taking a multi-vitamin specially designed for pregnant women at this point. Please check with your doctor for the dosage that suit your needs!

Can I drink coffee or have caffeine during pregnancy?

  • Doctors usually agree that having under 200mg of caffeine per day is perfectly safe for your baby.
  • This is equal to approximately 2 tall sized coffees or 2 espresso shots.
  • Caffeine is a substance which crosses the placenta, so the baby is having some along with the nutrients from you.
  • While limited amount of caffeine will not affect the baby, large amount of caffeine intake has been associated with increased miscarriage. It may also prevent you from getting enough rest during the pregnancy.

Can I smoke in the pregnancy?

  • It is strongly recommend expecting mums to quit smoking before conception or as early as possible in the pregnancy, as smoking increases the risk of many health problems in the mum and baby, such as premature delivery and low birth weight.

How much alcohol can I drink in pregnancy?

  • Unfortunately, no “safe amount” has been determined for alcohol consumption in pregnancy. We would strongly recommend you to refrain from drinking any alcohol during the pregnancy, as it has been linked to Fetal Alcohol Syndrome, a form of mental retardation in the fetus. Would you like to view some information quitting alcohol?

Do I need to change my Lifestyle when pregnant ?

Can I have perm or dye my hair in pregnancy?

  • Even though no evidence suggests the small amount of chemicals absorbed through the skin during hair coloring is harmful to you or the baby, some experts still advise waiting out the first trimester before any type of hair dying. Check with your doctor for his or her opinion. If you’re uncomfortable with a full dye job, consider highlights instead of single-process color.
  • Although hair perming and straightening are perfectly safe in pregnancy, you may not get the results you are hoping for. This is because hair responds unpredictably under the influence of pregnancy hormones. Therefore, feel free to use mechanical curlers or straightening irons that are chemical free, but be prepared to make peace with your new pregnancy hair!

Can I use sauna or steam room or hot tub in pregnancy?

  • Activities that sustain a high body temperature are better to be avoided in pregnancy.
  • This is because high temperatures are harmful for development of embryo and fetus, especially in the first and second trimester on brain and spine development.
  • Furthermore, the heat might lead to dehydration or dizziness, which becomes risk factors for falls.
  • The same goes for hot tubs, steam rooms, and Japanese Onsen. Quick hot showers are fine, so there is no need to switch to cold showers.

Can I have manicure / pedicure in pregnancy?

  • It’s perfectly safe to have your nails painted while pregnant.
  • There are, however, ways to make your experience even safer. Refrain from breathing in the fumes of nail polish for a prolonged time.
  • This can be done by asking for nontoxic polish, finding a well-ventilated salon, and/or wearing a mask. Ask the beautician to take extra precautions not to break any skin (i.e. during callous removal), as it can introduce infections.
  • If you do gels, ask for specially made gloves that cover your hands, exposing only your nails to the UV light (or frequent a nail salon that uses LED light).

How can I prevent stretch marks?

  • Stretch marks are caused by small tears in the supporting layers of the skin when your belly expands during pregnancy.
  • Most pregnant ladies will walk away from pregnancy with them – almost like a badge of honour! But we recognize that they may be undesirable.
  • To do your part in preventing stretch marks in your pregnancy, try to gain weight steadily and gradually, as the faster skin stretches, the more likely the stretching is to leave its mark.
  • Promoting elasticity in your skin by keeping a regular exercising and eating habit with vitamin C rich foods. Some women find that creams designed to reduce stretch marks are effective in preventing stretch marks, so you may apply your favorite cream or moisturizers, as they will at least prevent the dryness and itching associated with pregnancy.

Can I have facials in pregnancy?

  • Most facials are safe during pregnancy, and is a great way to clean out the excessively clogged pores due to pregnancy hormones.
  • Make sure they don’t contain ingredients that may harm the baby, such as vitamin-A derivatives. Some of the more aggressively exfoliating treatments may make sensitive skin during pregnancy worse.
  • Avoid facials that use an electrical microcurrent or lasers, as safety measures are variable. Let your beautician know that you are pregnant, and ask for preparations that are soothing and least likely to provoke a reaction. If you’re unsure about a particular treatment’s safety, check with your practitioner before going for it.

Are phone screens/computer screens harmful for the baby?

  • That’s a popular question! Most studies done on this subject have shown that the radiation emitted from electronic screens does not directly cause harm to the pregnancy. However, there are two ways that mobile devices indirectly cause harm to you and your baby.
  • Pregnant women are at higher risk of falling due to altered center of gravity and obstructed vision due to your baby bump. Walking while distracted by a mobile device can increase this risk, and falling in the pregnancy can cause serious harm!
  • The LED light emitted from your device screen can affect your circadian rhythm through suppressing the level of sleep hormone, melatonin. We would recommend switching off your mobile device 30 minutes to 1 hour before your planned bedtime!

Can I travel during the pregnancy?

  • Travelling by Car
  • Travelling by car is usually safe. Be sure to drive safely, and take frequent breaks to stretch your legs for lengthy trips. Keep nutritious snacks and water handy, and make sure the seat is comfortable by bringing along cushions for back support. Happy travelling!
  • Travelling by Train
  • Travelling by train is usually safe, but do check if there is a dining car, or pack enough meals and snacks for the ride. Booking a sleeping care if you are travelling overnight, as we would like you to be well rested during the pregnancy!
  • Travelling by Ship/Boat
  • If you’re planning to take a cruise ship or boat, do check with the organizer about any restrictions on pregnant women, and ask about medical facilities on board. Keep in mind that motion sickness may worsen nausea from any morning sickness, and as always, move about to stretch your leg often when you’re onboard to prevent blood stasis in your legs. It would be good to check with your doctor to see if your specific condition allows you to go on a cruise, and if you should carry any medication with you. Happy travelling!
  • Travelling by Airplanes
  • Airplane are usually safe for early pregnancy, but most airlines post restrictions on flying once you reach a certain point in the third trimester. Do check with your airline before booking the ticket. For any flight, try to get up and walk about every hour to prevent blood stasis in your leg, which could be a dangerous condition. Happy travelling!

 I have a bellybutton piercing – what should I do?

  • As long as your belly piercing is healed and healthy, you will not have to remove it until later in the pregnancy.
  • Your belly button marks where you connected to your own mom in the womb, not where your baby connects to you—which means a piercing won’t provide a path for pathogens to reach your baby. As you progress to the second and third trimester, you may find that your belly bar or belly ring becomes too uncomfortable to wear, tor start to rub or get caught on your clothing.
  • When that happens, it is best to remove the belly-button jewelry for the time being. We would not recommend getting your belly (or anywhere else on your body) pierced during pregnancy, due to the increased chances of infection.

Can I go for teeth whitening during pregnancy?

  • While there are no proven risks to tooth whitening during pregnancy, it is probably worthwhile to delay until after the pregnancy like most elective procedures involving chemicals, just to be on the super safe side.
  • Be sure to keep your teeth clean and well flossed, as gums are extra sensitive during pregnancy.

What should I wear during my pregnancy?

  • Generally, you are free to wear anything that makes your day!
  • However, do try to stay away from tight clothing especially around the belly area, including belts. This is because tight clothing may restrict your circulation and baby’s growth. Choose loose, comfortable and breathable clothing.

What should I wear high heels during my pregnancy?

  • Its best to stay away from high heels during pregnancy.
  • Not only do they increase the risk of fall, they also increase back pain. But hope is not all lost! You can go for lower wedges, and flats with good arch support are best!

What kind of exercise is recommended during pregnancy ?

Can I work out during the pregnancy?

  • Yes! In fact, we would recommend you to stay active throughout your pregnancy, as long as you listen to your body, and stop when it is causing physical discomfort.
  • However, do get clearance from your doctor about your particular exercise regime, especially if you have had complications during the pregnancy, such as bleeding.

Can I jog in pregnancy?

  • If you were not an avid runner before pre-pregnancy, stick to brisk walking for now.
  • If you are an experienced runner, you may stay on track during pregnancy but limit your time to 20 minutes, and stick to level terrain or use a treadmill.
  • Pregnancy hormones often soften your ligaments and joints, which means that running may be more impactful on your knees than before and make you more prone to injury. The bottom line is listen to your pregnant body and adjust your exercises accordingly!

Can I lift weights in pregnancy?

  • We don’t recommend lifting weights in the pregnancy, as the sudden increase in abdominal pressure in the upgoing motion of lifting can potential cause harm to your womb.
  • In fact, avoid lifting any heavy items at all, but if you must, do it slowly. First, stabilize yourself by assuming a wide stance. Next, bend at the knees, not at the waist. And finally, lift with your arms and legs, not your back.
  • If you have to carry a heavy load when you’re shopping, split it evenly between 2 shopping bags and carry one in each arm rather than carrying it all in front of you as this may cause you to lose balance.

What should we do with the family pets when pregnant ?

Should I give up family cat? Are cats dangerous for the baby?

  • The infection that you have heard of is probably toxoplasmosis, a parasite which gets transmitted in animal feces which could harm the baby’s brain.
  • There are a few alternatives if you don’t want to give up the cat entirely. You could get the cat tested for active infection by a vet, and ask a friend to care for them only if they’re infected. You could also hand off the litter-box duty to a family member, and always wash your hands thoroughly after touching your cat. Avoid touching stray cats during your pregnancy, as they are much more likely to carry the infection than indoor cats.

Will Sexually Transmitted Diseases affect my baby ?

I have/had a sexually transmitted infection (STI) – will this affect my baby?

  • Most STDs can affect pregnancy but most can also be easily and safely treated, even during pregnancy. If you’re not sure whether you’ve been tested for STDs, check with your doctor. Testing is a vital precaution to take in pregnancy, even if you’re pretty certain you couldn’t be infected with an STD. If a test does turn out to be positive, treatment (for both you and your partner, if necessary) will protect not you and your baby’s health.
  • It’s okay that you don’t remember what you diagnosis was. In fact, many women are often unaware of being infected at all. The Center for Disease Control recommends that all expectant mothers be tested early in pregnancy for the STDs most likely to pose a serious risk to mom and baby. Please check with your doctor to make sure that these tests are going to be done for you.
  • About Chlamydia Infections
  • Chlamydia is the most common infection passed from mother to baby, and is considered a potential risk to both. Because half of women infected with chlamydia don’t have symptoms, routine screening is important.
  • The best time to treat chlamydia is before pregnancy. But prompt treatment with antibiotics during pregnancy can prevent transmission of the infection to baby, which can include lung or eye infection. An antibiotic ointment is also routinely used at birth on the new infant to protects the newborn from chlamydial and gonorrheal eye infection.
  • About Gonorrhea Infections
  • Gonorrhea can cause conjunctivitis, blindness, and serious generalized infection in a baby if it is delivered through an infected birth canal. An expectant mom who tests positive for gonorrhea should be treated immediately with antibiotics. Treatment is followed by a “test of cure”, which is another bacterial culture to make sure that the mom is infection free. Furthermore, an antibiotic ointment is usually applied to the eyes of every newborn at birth to make sure we don’t miss anybody.
  • About Syphilis Infections
  • Syphilis can cause a variety of birth defects as well as stillbirth. Therefore, testing is done for all pregnant women at the first prenatal visit. Antibiotic treatment of infected pregnant women before the second trimester, when the infection usually begins to cross the placental barrier, can effectively prevents harm to the fetus in most cases.
  • About HPV Infections
  • HPV transmission to babies is very low—and even in the unlikely case that a baby does get the HPV virus, it typically clears without treatment. Genital warts caused by the HPV virus rarely affects the baby. However, the hormonal changes of pregnancy can cause the warts to multiply or get larger. The warts can be safely removed by freezing, electrical heat, or laser therapy. If they’re not impacting your pregnancy, this treatment may be delayed until after delivery.
  • If you do have HPV, your practitioner will also check your cervix to make sure there are no cervical cell irregularities, but any necessary cervical biopsies to remove the abnormal cells will likely be postponed until after the delivery.
  • About Herpes Infections
  • Herpes infection in a newborn is rare, especially if you are having a recurrent infection (that is, she’s had herpes before) during pregnancy.
  • If you had herpes infection before pregnancy, the risk to your baby is very low. To lower it even more, your doctor may give you antiviral meds beginning at week 36 of your pregnancy—even if you don’t have active lesions. If you end up having active lesions when labor starts, you’ll probably have a c-section to protect your little one from infection in the birth canal. In the unlikely event a baby is infected, he or she will be treated with an antiviral drug.
  • A herpes infection that appears for the first time in pregnancy increases the risk of miscarriage and premature delivery. If you haven’t had genital herpes before, and is now showing any signs of a primary infection (fever, headache, fatigue, and achiness for 2 or more days, accompanied by genital pain, itching, pain when urinating, vaginal and urethral discharge, and tenderness in the groin, as well as lesions that blister and then crust over), call your doctor immediately.
  • After delivery, the right precautions can allow you to care for and breastfeed your baby without passing along the virus, even during an active infection.”
  • About HIV Infections
  • At most hospitals, pregnant women are screened for HIV as early as possible during each pregnancy unless they decline the test. That’s because infection in pregnancy by the HIV virus, which causes AIDS, is a threat not just to the expectant mom but also to the baby. 25% of babies born to untreated mothers will have the virus. Fortunately, the treatments that are now available reduces this risk greatly. Treating an HIV-positive pregnant woman with antiretroviral drugs can dramatically reduce the risk of her passing the infection on to her baby, without any harmful side effects. For women with a high amount of HIV in their body, delivering by elective c-section (before contractions begin and before membranes rupture) can reduce the risk of transmission even more.

I have/had a vaginal infection (STI) – will this affect my baby?

  • Bacterial vaginosis (BV) is the most common vaginal condition in women of childbearing age, affecting more than three-quarters of all women and up to 16 percent of pregnant women. BV, which occurs when certain types of bacteria normally found in the vagina begin to multiply in large numbers, is often accompanied by an abnormal gray or white vaginal discharge with a strong fishlike odor, and rarely pain, itching, or burning. During pregnancy, BV is associated with a slight increase in complications, such as premature rupture of the membranes, amniotic fluid infection and pre- mature labor. It may also be linked to a slight risk of miscarriage and low birth- weight. Treating symptomatic BV with antibiotics during pregnancy may sometimes decreases the risk of complications, Be sure to mention any symptoms you may have to your practitioner so you can get the right diagnosis and treatment.
  • Yeast infections (also called “thrush” or candida) during pregnancy are more common than any other time in a woman’s life, especially during the second trimester. f you think you may be experiencing a yeast infection, the following information will prepare you to discuss the possibility with your doctor. Though yeast infections have no major negative effect on pregnancy, they are often more difficult to control during pregnancy, causing significant discomfort for you. Don’t wait to seek treatment!
  • The symptoms of trichomoniasis are a greenish, frothy vaginal discharge with an unpleasant fishy smell and, often, itching. About half of those affected have no symptoms at all. Though the disease does not usually cause serious illness or pregnancy problems (or affect a baby whose mom is infected), the symptoms can be irritating. Generally, expectant moms with symptoms of trichomoniasis are tested, and if found positive for the infection, are treated safely with antibiotics.

Ectopic Pregnancy

What are the symptoms of ectopic pregnancy?

  • The symptoms of ectopic pregnancy consist of missing your period, abdominal pain/cramps (especially one-sided), and vaginal spotting/bleeding.
  • If the ectopic pregnancy has caused rupture of the tube, there may also be dizziness or fainting due to low blood pressure.
  • If you are having these symptoms in early pregnancy (especially if you have not yet had an ultrasound to confirm that your fetus is safely inside the womb), please visit the emergency room immediately.
  • Ectopic pregnancy is a life-threatening condition! What are the different types of miscarriage?

What causes them?Common FAQ on Miscarriage

  • Generally, we classify miscarriages into five groups, based on the status of the baby and the womb
  • Threatened miscarriage is diagnosed when there is per vaginal bleeding but no cervical change or fetal loss. On ultrasound examination, the heartbeat of the baby is present and normal. The cause of this condition is not clearly understood, but some studies suggest that it can caused by challenges in the maternal hormonal environment (e.g. low progesterone) or even stress.
  • Missed miscarriage is diagnosed when the cervix is closed, and ultrasound shows that although the fetus remains inside the womb, the fetal heart beat has stopped. The majority of the cases are due to intrinsic abnormalities in the fetus itself, such as chromosomal defects. Few cases are due to infections or toxins in early pregnancy A surgical procedure called dilation and curettage may be needed to clean out the womb.
  • Inevitable miscarriage is diagnosed when there is vaginal bleeding accompanied by dilation of the cervix, while an early fetus may still remain in the womb. In this case, miscarriage is inevitable because a dilated cervix is not likely to close and keep the fetus safe inside the womb, and the fetus is not able to survive environment outside of the womb until at least 24 weeks gestation. Inevitable miscarriage can be due to fetal abnormalities or maternal anatomical problems. Speak to your doctor when planning another pregnancy.
  • Partial miscarriage is diagnosed when there is vaginal bleeding with partial passing of products of conception (e.g. part of placenta, fetus). The majority of the cases are due to intrinsic abnormalities in the fetus itself, such as chromosomal defects. Few cases are due to infections or toxins in early pregnancy. A surgical procedure called dilation and curettage may be needed to clean out the womb.
  • Complete miscarriage is diagnosed when there is vaginal bleeding with complete passing out of any products of conception (e.g. entire placenta, fetus). The majority of the cases are due to intrinsic abnormalities in the fetus itself, such as chromosomal defects. Few cases are due to infections or toxins in early pregnancy. Unlike partial miscarriage or missed miscarriage, a procedure to clear the womb may not be needed if there is ultrasound evidence that all products of conceptions have been passed out.
  • The management of threatened miscarriage is still under debate and research.

I have been diagnosed with threatened miscarriage – should I take progesterone pills?

  • There is no clear evidence showing that progesterone pills can prevent a miscarriage, especially when maternal progesterone levels are already in the normal range (in these cases, the threatened miscarriage is not due to lack of progesterone, so supplementation are unlikely to help).
  • Therefore, the usage of progesterone depends on the country and your doctor. In some institutions, a progesterone blood test is available, and progesterone supplementation is only given if levels are below normal. In any case, progesterone supplementation has little side effects.
  • Please note that progesterone may be used for different purposes in the pregnancy, such a luteal phase support in an IVF pregnancy.

I have been diagnosed with threatened miscarriage – should I keep to bedrest?

  • Bedrest may be beneficial if you’re diagnosed with threatened miscarriage, but be sure to prevent other pregnancy complications, such as deep vein thrombosis (bloodclot in the leg veins due to immobility), but purchasing a pair compression stocking.
  • If you’re still experiencing bleeding – see doctor to get rest from work. Do not do strenuous activity. Avoid sexual intercourse for the time being.

FAQ on Down Syndrome

What is Down Syndrome?

  • Down syndrome is a genetic disorder caused when abnormal cell division results in an extra full or partial copy of chromosome 21.
  • This extra genetic material causes the developmental changes and physical features of Down syndrome. Down syndrome varies in severity among individuals, causing lifelong intellectual disability and developmental delays.
  • It’s the most common genetic chromosomal disorder and cause of learning disabilities in children.
  • It also commonly causes other medical abnormalities, including heart and gastrointestinal disorders. (Definition adapted from Mayo Clinic)

What Test are available for Downs Syndrome?

  • A number of tests are available to screen for Down syndrome, and they usually can be done from 11 weeks onwards.
  • 11 to 13 Weeks
  • Between 11-13, the most common and widely used form of screening is called the First Trimester Screening (FTS), also called the Oscar test. This test consists of a simple blood test and an ultrasound to look the neck thickness and nose bone of the baby. These parameters are combined to give you an overall risk. A calculated risk smaller than 1/300 of having Down syndrome is considered low-risk. A calculated risk greater than 1/100 is considered high-risk. A calculated risk between 1:100 and 1:300 is considered medium risk. A medium risk or high-risk test result warrants further investigation.
  • More then 13 Weeks
  • If you have missed the 11-13 week screening period, fret not, there are still two alternative screening option! One is called Maternal Serum Screening (MSS). It is a simple blood test that uses several hormonal levels to calculate an overall risk, and can be done in most maternity hospital. However, this test is not as accurate as the Oscar test/First Trimester Screening done between 1-13 weeks. Another more accurate test is called the Non-Invasive Prenatal Test (NIPT).
  • About NIPT test
  • NIPT (Non-Invasive Prenatal Test) is a recent innovative medical development, where a special blood test is done to extract fetal DNA from the maternal bloodstream. It is a non-invasive test that enjoys high sensitivity of 99% (i.e. very likely to pick up almost all Down Syndrome cases), compared to 90% sensitivity in the First Trimester Test. Keep in mind that it is a screening test, not a diagnostic test. Some mothers feel adequately confident by the result a 99% sensitive screening test, while others prefer to go for a definite diagnostic test – namely amniocentesis or chorionic vili sampling (CVS). Click the link to find out more.
  • Downs Syndrome Diagnostic Test
  • If you receive a high-risk Down Syndrome screening test, we would recommend that you go for a diagnostic test. Since you are currently before 13 weeks gestation, the most appropriate diagnostic test is chorionic vilic sampling (4.1). Cells from tiny fingerlike projections on your placenta called the chorionic villi are taken and sends them to a lab for genetic analysis. This procedure is only done by obstetric specialists.
  • If you receive a high-risk Down Syndrome screening test, we would recommend that you go for a diagnostic test. Since you are currently at or after your 13 weeks of gestation, the most appropriate diagnostic test is amniocentesis (4.1). A small amount of amniotic fluid, which contains fetal tissues, is sampled from the amniotic sac surrounding a developing fetus, and then the fetal DNA is examined for genetic abnormalities. This procedure is only done by obstetric specialists.

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A/Prof Tan Thiam Chye
MBBS (S'pore), M.Med(O&G) (S'pore) Head & Senior Consultant Department of Obstetrics and Gynaecology KK Women's and Children's Hospital Director (Clinical), Office of Patient Experience Deputy Director (Education), KKH Campus Associate Professor Duke - NUS Graduate Medical School Singapore

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