Prenatal Care

Prenatal Care

What is prenatal care?

During your pregnancy journey, you will need regular checkups to ensure that both you and the little one you are carrying are healthy. Prenatal care does just that.

Supported by a large team of senior foetal medicine specialists and paediatric cardiologists, Parkway East Hospital provides a comprehensive range of prenatal diagnostic evaluation and treatment.

Prenatal diagnostics are a form of health screening that allows our medical specialists to perform detailed tests that help to:

Determine the health of you and your baby
Track your baby's development
Identify your baby's gender
Identify congenital defects or medical conditions and support timely intervention, if needed.

Here is an overview of prenatal tests and services you can expect to receive over the course of your pregnancy trimesters.

Ultrasound scan to confirm the pregnancy and its location, check your baby's heartbeat and estimate the due date.
Chorionic villus sampling is recommended for high-risk pregnancies and typically done between 10 – 12 weeks of pregnancy to check for genetic defects. A small sample of placental tissue (the chorionic villus) is removed for analysis.
Blood tests to assess your pregnancy and health condition.

An ultrasound known as a foetal anomaly scan is done at around 18 – 20 weeks to assess the development of bones, organs and other structures. It is also used to determine gender and check the position of the placenta and the amount of amniotic fluid.
Foetal echocardiogram is done at around 18 – 24 weeks to look at the anatomy of the heart and check its function. This test provides 3D reconstruction and real-time 4D imaging.
Amniocentesis, also known as the amniotic fluid test (AFT), helps to diagnose chromosomal abnormalities such as Down syndrome, Edwards syndrome and Turner syndrome. It is also used to check for gender, foetal lung maturity and foetal infection. It is typically done between 15 – 20 weeks for high-risk pregnancies.
Foetal blood sampling (FBS) is done to check for chromosomal disorders, genetic diseases and viral infections. Conducted between 20 – 23 weeks, blood is drawn from the umbilical cord of the foetus.
Checks for gestational diabetes and anaemia as well as antibodies.
Immunisations against influenza and whooping cough.

Ultrasound scans (including 2D and 3D scans) to check on your baby's development
Group B streptococcus screening

Understanding your pregnancy journey

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First trimester

The first trimester is the first 12 weeks of your pregnancy, starting from the first day of your last menstrual period. By the time you realise you are pregnant, you may already be in your 5th or 6th week of pregnancy!

The first trimester is often a time of great joy and anticipation for couples, and you’ll discover a lot of changes in yourself and your baby. As your baby grows from a fertilised egg into a foetus, an ultrasound around the 6th week of pregnancy will allow you to listen to its heartbeat. By the 12th week, your baby is almost as big as a lime, with all the vital organs of the body formed.

The first trimester experience is different for every woman. Some women sail through this period with few symptoms, while others struggle with nausea and fatigue. Nausea, often called morning sickness, is one of the most common symptoms in the first trimester. It is usually worst in the morning, but some women may have nausea throughout the entire day. Other symptoms that may be experienced in the first trimester include soreness of breasts, vaginal discharge, and mood swings.

Second trimester

The second trimester spans the 13th – 27th week of your pregnancy. This is often called the “honeymoon” period of your pregnancy, where you likely feel better both physically and emotionally. By now, the raging hormones that had caused the bothersome symptoms during the first trimester have finally settled. As the symptoms subside, you may start to notice a surge in your energy levels.

This is an exciting time for couples as you can feel your baby move for the first time at around the 20th week of your pregnancy. You can also learn the sex of your baby through an ultrasound. As your baby continues to grow bigger in the second trimester, your belly will also expand and your baby bump will become noticeable.

Some women may experience minor, irregular cramping in the lower abdomen, especially after physical activity or sex. You may also develop leg cramps, stretch marks, and darkening of the skin especially over the face and abdomen.

Third trimester

The third trimester is the last stretch of your pregnancy. By now, you are probably eagerly preparing for your baby’s arrival and nervously anticipating the childbirth process. Most women find the third trimester the most challenging phase of pregnancy.

By the third trimester, your baby can weigh somewhere around 2 – 4 kg. With a growing and active baby occupying most of your belly, you may face struggles such as heartburn, a frequent need to urinate, backaches, varicose veins and haemorrhoids. As your due date approaches, your doctor will advise you to come in more frequently for check-ups.

Over the 9 months of pregnancy, you will experience numerous changes to your body that are necessary to assist with foetal development and prepare for labour.

Some commonly known changes include skin stretches, weight gain, swelling in ankles and feet due to extra fluid in the body, a slight increase in body temperature during the first 16 weeks, morning and evening sickness during the first trimester, and leg cramps due to weight gain. You can also expect the following:

Changes to the breasts

Due to increased levels of the hormones oestrogen and progesterone, the expectant mother’s breasts may become tender and increase in size in preparation for breastfeeding during delivery. Your nipples may protrude more. By the third trimester, a yellow, watery pre-milk known as colostrum may start leaking from the nipples.

Hormonal changes

By weeks 10 – 12, the placenta acts as a temporary gland to produce large amounts of oestrogen and progesterone, hormones that are vital in creating and maintaining the conditions required for pregnancy. The increased hormonal levels may cause pregnant women to have an increased basal metabolic rate, feel warmer and experience ‘hot flushes’. Some women will also experience changes in hair and nail texture and growth during pregnancy.

Nearing the end of the third trimester, the posterior pituitary, which is a gland in the brain, will start secreting the hormone that kickstarts the birthing process via contraction of muscles in the uterus. During delivery, the posterior pituitary will start secreting a hormone that stimulates the production of breast milk.

Changes to the heart & cardiovascular system

During pregnancy, more blood vessels grow and blood volume increases within the cardiovascular system. The pressure of the expanding uterus on large veins also causes the blood to slow in its return to the heart. This leads to increased cardiac output, elevated resting heart rate, and a decrease in blood pressure during the second trimester.

Changes to the stomach & digestive system

Pregnancy may bring about increased gastric reflux and heartburn, and increase in constipation symptoms, due to the womb rising to the upper abdomen. By the end of the second trimester, the top of your womb will be near the rib cage. This action pushes the intestines and stomach upwards, resulting in changes to your regular bowel movement. The stretching of the abdominal wall and ligaments supporting the uterus may also cause abdominal discomfort and pulling pains.

Changes to the urinary system

Pregnancy increases the workload for both kidneys due to extra waste from fetus. The expanding uterus also places pressure on the urethra, bladder, and pelvic floor muscles. This may lead to temporary bladder control problems and frequent urination.

Changes to the musculoskeletal system

During pregnancy, the spinal curvatures realign to maintain balance, which results in a posture shift usually seen in women later into their pregnancy. The ligaments that hold the pelvic bones together also gradually loosen during pregnancy to prepare the mother for labour and birth.

Pregnancy should not hamper the sexual relationship between parents-to-be, as long as your pregnancy is progressing normally and no vaginal bleeding or vaginal infection occurs. The amniotic sac, uterus muscles, as well as the thick mucus plug that seals an expectant mother’s cervix helps to guard the developing foetus against any form of shock or infection. However, pregnancy may bring about hormonal or mood fluctuations, as well as physical changes to a woman’s body that may dampen sexual drive.

During pregnancy, it is common to feel anxious, confused, sad or angry as a result of changes to hormonal levels and physique. In some women, pregnancy and birth may trigger severe depression. Symptoms of depression include:

Having negative thoughts about yourself and your baby
Feeling sad and hopeless
Being unable to sleep well
Loss of appetite
A lack of interest in life
Crying for no reason

Women who are pregnant should take their feelings seriously, as negative emotions experienced during pregnancy may lead to more severe illnesses post-delivery. It is important to realise that changes to the body during pregnancy are temporary, and part of the miracle of life.

Depression after giving birth may be a sign of postnatal depression. This can develop during the first 6 months after birth, and can last for over a year if left untreated. Early diagnosis helps with prompt treatment and care. If you do not feel right, or notice yourself feeling worried or sad, seek help by talking to your family physician, obstetrician or therapist.

Adequate nutrition and eating healthy are more important than ever during pregnancy. An expectant mother will need more calcium, iron, protein, folic acid and other essential nutrients to support both herself and the growing fetus. However, ‘eating for 2’ does not mean consuming twice as much. Obstetricians recommend taking sensible, balanced meals that are packed with nutrients during pregnancy.

Talk to your obstetrician to understand the daily nutritional requirements for an expectant mother, cravings and food aversions, and the recommended weight gain throughout pregnancy.

Most pregnancies occur smoothly. However, at times, issues may occur that affect the health of both the mother and baby. Common pregnancy complications include:

Gestational diabetes
Preeclampsia
High blood pressure
Preterm labour
Miscarriage
Bleeding in pregnancy, due to reasons such as low placenta

Certain medical conditions may also lead to higher risk of pregnancy complications. Some examples include diabetes, high blood pressure, cancer, anaemia, or sexually transmitted diseases. Other risk factors for pregnancy complications include:

Eating disorders such as anorexia
Pregnancy at age 35 or older
Smoking or alcohol intake
History of pregnancy loss or preterm birth

If you have a chronic condition or illness, talk to your obstetrician to understand how you can minimise your complications before and during pregnancy. Even with complications, early detection and proper prenatal care can help to reduce the risk for both the expectant mother and baby.

Plan your prenatal care plan at Parkway East Hospital

Your prenatal care plan is dependent on many factors, including your age, pregnancy history, and pre-existing health and medical conditions.

Our experts at Parkway East Hospital are sensitive to your needs and goals and will work with you on your prenatal screening plan.

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