4If you are underweight during pregnancy

If you are underweight before pregnancy, or not putting on enough weight during pregnancy, you can still follow the Healthy Diet Pyramid for Pregnancy. Increase the number of servings consumed from each food group. If you are unable to eat more food, you can also increase your weight by Snacking on healthy snacks like nuts, dried fruits, cheese, desserts (tauhuay, tauswan, red bean soup) in between meals. Drinking 1-2 cups of soybean milk, fruit juice, malted milk drinks (e.g. Milo, Ovaltine,...

Twin Pregnancy DoubCe Joy or DoubCe Trouble

There are two things in life for which we are never fully prepared, and that is twins. You are unique if you are carrying twins Twins occur only in one in every 80 pregnancies. There are many unique issues in twin pregnancies, which you will need to understand. One third of twins are identical and two-thirds non-identical. In identical (monozygotic) twins, one egg is fertilized by one single sperm, but the egg divides into two embryos soon afterwards. Thus, both twins have the same genetic...

3If you have phenylketonuria PKU

People with PKU have a deficiency of an enzyme, which is necessary for the proper metabolism of an amino acid called phenylalanine. Serum phenylalnine level at conception is critical to the organ development of the fetus. Elevated maternal blood levels of phenylalnine may cause spontaneous abortion, brain and heart defects, poor fetal growth, as well as mental retardation in the baby. If maternal blood levels of phenylalnine are optimized by special diet prior to conception and during...

Hepatitis B

Hepatitis B is a liver infection caused by Hepatitis B viruses. The infection can be acute or chronic. Most chronic carriers have no symptoms. You can become infected by Hepatitis B through sexual contact or by exposure to infected body fluids such as saliva. If you are a chronic carrier of Hepatitis B, you can pass the infection to your baby. Infected infants do not appear to be at a higher risk of birth defects. However, they have a 25 chance of dying from liver-related diseases such as...

Varicella zoster Chicken Pox Infection

Like rubella, chicken pox is very infectious. As with the rubella virus, the Herpes zoster virus spreads when you inhale droplets of respiratory secretions exhaled by an infected person. A non-immunized person may catch chicken pox by being in the same room with an infected person. Symptoms may not appear until ten days to three weeks after infection. The patient often has fever and lethargy, followed by an itchy rash of watery blisters. The blisters will burst after a week and form crusts...

Pre Pregnancy Preparation

I Before you were conceived, I wanted you. Before you were born, I loved you. Before you were here an hour, I would die for you. This is the miracle of Mother's love. Pregnancy is an exciting and rewarding experience for any woman. Prepregnancy preparation is essential in the journey of pregnancy. Being well prepared would optimize your chance of a smooth pregnancy and healthy baby. It prepares you both physically and emotionally. Now that you have decided to embark on the journey of...

2If you have high blood pressure during pregnancy

In those suffering from long standing essential hypertension (even before pregnancy), antihypertensive medications and a low-salt diet is advocated to help treat this condition. In hypertension that arises only during the course of the pregnancy (gesta-tional hypertension or preeclampsia), the only definative cure for this condition is through the delivery of the baby and the placenta (see Chapter 21). However, while not a cure for pre-eclampsia, limiting salt intake is advised.

Calculate Your EDD

Your baby was conceived about 14 days after the first day of your LMP. EDD is at 40 weeks that is 40 weeks after the first day of your last menstrual Calculate the expected date of delivery (EDD) using Naegle's rule 280 days from the first day of the last menstrual period (LMP), i.e. EDD LMP (first day) + 7 days, and then going forward 9 months For example If the LMP is 11 5 2007, EDD 11 + 7 (day), May + 9 months, i.e. 18 2 2008 (This rule is based on a menstrual cycle of 28 days and assumes...

1Folate also known as folic acid

Folate is vitamin B, which is essential for cell division and organ formation. This nutrient helps prevent neural tube defects (malformations of the brain and spinal cord) in your developing baby and anemia in pregnant woman. Due to the severe nature of neural tube defects, we strongly advise adequate folate intake of at least 800 micrograms daily before conception and throughout the first three months of pregnancy. Dark green vegetables, for example, spinach, broccoli and asparagus citrus...

Meconium Bloodstained Liquor and its Implications

The liquor (amniotic fluid) is monitored throughout the labor. Thick meconium staining liquor indicates that the baby has passed motion inside the mother's womb. This could be associated with fetal distress and the doctor may expedite delivery. There is also a worry that the baby may aspirate (breathe in) the meconium stained liquor, resulting in lung infection and injury. If the liquor is heavily blood stained, premature separation of the placenta (placenta abruption) needs to be excluded....

VaginaC Discharge During Pregnancy

Most women would notice an increase in vaginal discharge during pregnancy. This is quite normal and is caused by a combination of factors increased blood supply, softening of the cervix and vaginal walls, and later, stimulation from the baby's head, as he or she presses against the cervix ready for labor. Normal vaginal discharge is clear, white or creamy, and fairly runny. It may have a distinctive odor, but not an unpleasant smell. Signs of infection include thick, curd-like or greenish...

TCM and Habitual Miscarriages

A miscarriage may be triggered by several reasons, which greatly depend on the health status of both the mother and the fetus. Miscarriage may also be related to unhealthy lifestyles such as excessive alcohol intake and smoking. If three consecutive miscarriages occur, this condition is known as habitual (recurrent) miscarriages. In TCM, treatments include replenishing the Qi, nourishing the Blood and strengthening the physiological functions of the spleen. To replenish the body's Qi and...

Screening Scan Week 1822

Being an expectant mother, you will find it reassuring to know that your baby will be born healthy with no congenital deformities. An ultrasound scan can be used for screening to look for abnormalities in the physical structure of Figure 14.5 Ultrasound scan showing Figure 14.6 Ultrasound scan of baby's spine. normal heart structures of baby. Figure 14.5 Ultrasound scan showing Figure 14.6 Ultrasound scan of baby's spine. normal heart structures of baby. Figure 14.7 3-D ultrasound picture...

1Vaginal candidiasis moniliasis or thrush

This is a common and frequently distressing fungal infection for many women during pregnancy. It does not harm the baby during pregnancy or childbirth. Having vaginal thrush can cause extreme itch and clumps of white discharge. Because of the hormonal changes, pregnant women often get thrush, especially during the third trimester of pregnancy. Fortunately, it does not cause the baby any harm and can be easily treated by vaginal pessaries and cream. It may recur throughout pregnancy but usually...

What Do I Expect During My First AntenataC Visit

A baby is something you carry inside you for nine months, and in your heart till the day you die. These ten months of antenatal period is a wonderful time for you to enjoy. However, it is crucial that you remain healthy, both physically and emotionally, to enjoy your pregnancy. Antenatal care is part of this preparation and your first visit to your obstetrician after your pregnancy has been confirmed is an important occasion.

What Causes Genetic Disorders

Every child inherits 23 pairs of chromosomes from each parent one from the mum and one from the dad. Each chromosome contains thousands of genes. Genetic disorders can be caused by abnormalities in the number of chromosomes (which are your genetic make up) or a defect in a single gene. In most instances, the genetic disorders are caused by a single gene defect or what is commonly known as Mendelian genetics. These gene defects may be classified as genes is defective and overrides the normal...

Delivering in a Restructured Maternity Hospital

In a restructured maternity hospital like KK Women's and Children's Hospital, there are specialists on duty round the clock to attend to any problems that you may encounter in your entire pregnancy. Consultation, blood tests, ultrasound scans and medications are all available at affordable rates. Private care is also available in the restructured hospital. You will be able to choose your own obstetrician who will look after you throughout the entire pregnancy. Of course, he she will attend to...

Scientific Basis for Gender Selection

One of the theories suggested is that the sperm with the Y chromosome, known as the androsperm resulting in a male offspring , is tiny and fragile but moves very quickly. On the contrary, the sperm with the X chromosome, known as the gynosperm resulting in a female offspring , is larger and hardier with a longer lifespan, but moves rather sluggishly. Therefore, the male sperm would race to meet the egg much faster than the female sperm. But they have a shorter lifespan and would not be able to...

4Royal Jelly Feng Huang Jiang

a Protects against infections and increases resistance to diseases. b Accelerates the formation of bone tissue and helps wound healing. c Moisturizes dry skin and soothes dermatitis. d Increases endurance and energy levels. It also improves libido. a Allergic reactions most common from oral intake of royal jelly can range from very mild e.g. mild gastrointestinal upset to more severe reactions, including asthma, anaphylaxis shock , intestinal bleeding, and even death in people who are...

Foods to Avoid

Food safety is extremely important during pregnancy. This is because bacterial toxins and certain harmful chemicals such as alcohol and methylmercury can pass from mother to baby, and cause undesirable outcomes. The list below shows the foods to be avoided Unpasteurized milk soft cheeses, e.g. Brie, feta, Camembert and Roquefort liver pates and uncooked hot dogs, ham and luncheon meats These foods are prone to Listeria monocytogenes, a bacteria that causes lis-teriosis, which may result in...

For Vaginal Candidiasis yeast infection in Pregnancy

Butoconazole Gynofort vaginal cream Each pessary contains 200 mg clotrimazole Each pessary contains 600 mg isoconazole nitrate Metronidazole Nystatin Flagystatin pessary Each pessary contains 500 mg metronidazole and 100 000 units nystatin Useful in treating bacterial vaginosis vaginal infection as well Each pessary contains 100 000 units nystatin Each pessary contains 100 mg tioconazole Betamethasone valerate Betnovate cream Isoconazole Diflucortolone valerate Travocort cream Broad-spectrum...

Myths Associated with An Epidural Analgesia

There are many side effects associated with an epidural usage. Some minor side effects may occur but they are often minor, transient and self-limiting. These include Loss of feeling and muscle weakness Numbness of the legs and lower part of the body is to be expected. The urge to pass urine may also be lost momentarily, but this can be rectified by intermittent drainage of the urine by the midwife. As the epidural drug effect wears out, sensation and strength of the legs and lower body are...

For Pregnancy Supplementation cont

DHA For example Natal Care Plus, Neurogain Natal Care Plus 1 to 2 capsules 100 to 200 mg once a day Docosahexaenoic acid DHA is an omega-3 fatty acid, which is required for baby's normal brain and eye development. Neurogain 1 capsule 250 mg once a day The recommended daily intake of DHA during pregnancy is 300 mg daily. Iron supplementation for patients with iron deficiency anemia contains iron II salts Iron supplementation for patients with iron deficiency anemia contains iron III polymaltose...

Pregnancy and Breastfeeding

Wherever the art of medicine is loved, there is also a love of humanity. This chapter contains medications that are commonly used and safe for pregnancy and breastfeeding. This list is not exhaustive and you are advised to consult your doctor before taking medication. For fever, headaches and body aches pain Recommended for pregnant and diabetic individuals as it does not contain alcohol Pholcodine Bromhexine Durotuss Expectorant does not contain lactose, gluten, color,

Female Factor Subfertility

Windsock Deformity

In the female, any factor that prevents the sperm from reaching the egg ovum in the fallopian tube will result in subfertility refer to Figure 5.3 . Anovulation failure of the ovaries to produce an egg This commonly results from stress, excessive weight loss or exercise, poor nutrition, chronic medical conditions, inherent ovarian problems such as polycystic ovarian syndrome or previous ovarian surgeries. They usually manifest as an absence, delay or irregularity in the menses. Figure 5.3...

Use of Pregnancy Calendar Wheel

Most obstetricians are familiar with the pregnancy calender wheel Figure 8.1 . It helps estimate the EDD based on the LMP or dating scan. Do not be too worried if you have irregular periods or cannot recall your LMP. The most accurate dating is from Your baby's heart can be seen after 6 weeks of LMP. At this stage, the baby's length is now 4 mm. The embryonic period starts and your baby's organs start to form. Hair begins to sprout by then. Brain waves can also be detected. Your baby's heart...

Cant Get Pregnantl Is There Anything Wrong

Hydrotubation Pictures

Victory belongs to the most persevering. Conception can only happen when a sperm swims up into the womb before fertilizing an egg in the fallopian tube. This allows the fertilized embryo to implant or embed itself into the womb lining, where it will grow into a fetus. There is indeed a possibility that something is wrong in you or your partner if you are still not pregnant after a period of trying to conceive. An average couple in their 30s will conceive after about 6 months of trying to do so....

Screening Tests FTS or MSS

Baby Has Long Nasal Bone Down Syndrome

Screening tests do not tell you if your baby has Down Syndrome. Their purpose is to tell you if your fetus belongs to a low or high risk group. If the screening test shows that there is a high risk of your baby being affected, you will be offered a diagnostic test see below to confirm it. Screening tests are noninvasive hence, there is no risk of miscarriage to the baby. First trimester screening FTS This consists of a detailed ultrasound scan of your baby at 11-14 weeks gestation to measure...

Preface Child Birth

Pregnancy is a very exciting time for every woman. Feeling your baby grow inside you is a unique and wondrous experience. Many couples, however, experience some degree of anxiety and uncertainty. For some, this may be their first pregnancy. Some might have developed complications during the previous pregnancy and are worried about the current pregnancy. Every woman wants a smooth pregnancy, easy delivery and a healthy baby. Knowing more about pre-pregnancy preparation, understanding pregnancy,...

Book Reviews

The New Art and Science of Pregnancy and Childbirth is very well written by experienced obstetricians who together have many decades of collective experience in the care of thousands of women through their pregnancies. They are clearly cognisant of all the fears and anxieties that every pregnant woman faces and the answers to these are found in the pages of this book. I'm sure this book will help make this special period in a woman's life even more enjoyable. I would highly recommend this book...

From Kk Womens And Childrens Hospital

Consultant Psychiatrist Head, Mental Wellness Service For Chapter on Baby blues and depression and Co-contributor for Pregnancy loss and ways to cope For Chapter on Exercise in pregnancy Department of Neonatology and Child Development Unit For Chapters on Care of the newborn and Baby's vaccination For Chapter on I want a painless labour For Chapter on Eating right for breastfeeding For Chapter on Nutrition during pregnancy - eating right for two For Chapter on What should I pack before my due...

A6out The Authors

An Obstetrician and Gynecologist in KK Women's Hospital and writer, Dr Tan Thiam Chye co-authors the internationally best-selling Practical O amp G Handbook for the General Practitioner. Being a proponent of medical education, he is a faculty teacher in Duke-NUS Graduate Medical School and co-ordinates the OBGYN curriculum since 2007. He takes charge of OBGYN junior doctors' training and education programmes since 2004. A regular newspaper and magazine advice columnist, he also frequently gives...