Maternal Foetal Medicine

Our hospital provides a range of Maternal-Foetal Medicine services. Our aim is to ensure that all pregnant women have a pleasant experience during pregnancy, in labour and after delivery. Besides looking after women with normal pregnancy, our services include clinical management of women with various medical conditions and management of pregnancies with foetal abnormalities.
 

Antenatal Diagnostic Centre

Our Antenatal Diagnostic Centre (ADC) is the nerve centre of the Division of Maternal-Foetal Medicine under the Department of Obstetrics and Gynaecology at National University Hospital. It provides a comprehensive range of services for screening, diagnosis, counseling and management of foetal abnormalities during pregnancy. The centre is equipped with five state-of-the-art Diagnostic Ultrasound Machines, including a machine with 3D/4D capability.

Ultrasound scanning is performed by five dedicated Ultrasonographers, each with more than 12 years of experience in Prenatal Ultrasonography. Five senior consultants take turn to supervise and provide expert advice whenever required. Our patients are referred to ADC by NUH clinics as well as specialists in Singapore and neighboring countries.

The centre aims to provide parents and obstetric caregivers the knowledge to make informed decisions about the pregnancy, using a comprehensive range of resources, from advanced imaging using 3D ultrasound, invasive and non-invasive testing of genetic diseases to life-saving foetal therapy.

The services offered can be broadly divided into 3 categories: Screening, Diagnostic and Treatment options.

Screening Services

1. First trimester non-invasive screening for Down syndrome – using nuchal translucency and serum biochemistry (PAPP-A and Beta-hCG). The result of the combined screening test, including blood test result, is made available within 2 hours.
    

2. Second trimester serum biuochemistry (triple test) screening for Down syndrome.

Diagnostic services

3D Ultrasound, Multivessel Foetal Dopplers and Foetal Echocardiography are the major strengths of the centre in Prenatal Diagnosis. Our full ranges of services that can help in the detection of foetal abnormalities include:

1. Targeted 2D ultrasound imaging (Foetal Abnormalitiey Scans 20-22 weeks, Growth Scans - 24 weeks onwards, Biophysical Foetal Assessment).
    

2. Doppler blood flow studies of foetal and uterine vessels.
    

3. Foetal Echocardiography with 3D/4D imaging of foetal heart.
    

4. 3D reconstruction and real-time 4D imaging.
    

5. Invasive testing including:
   - Chorionic Villous Sampling (CVS) at 11-13 weeks
   - Amniocentesis at 15-20 weeks
   - Detailed Chromosome Analysis results available in 10-12 days
   - Foetal; blood sampling
   - Cordocentesis.
    

6. Molecular biologic testing for single gene disorders eg. Thalassaemias, Muscular Dystrophies, etc.
    

7. Rapid Karyotype with results available within one working day. The highlight of this service is that first trimester screening and diagnosis for Down Syndrome can be performed on the same day as nuchal and serum biochemistry screen, followed by CVS for screen-positive cases. Presence or absence of Down Syndrome can be confirmed within 24 hours.

Treatment Options

1.    Therapeutic Amnioinfusion


2.    Serial Amniodrainage for Twin-twin Transfusion Syndrome


3.    Treatment of foetal heart failure


4.    Foetal drug treatment for Cardiac Arrhythmias.

 

High Risk Pregnancy Clinic

This clinic is currently held two days a week. The clinics are run by consultants in the Division of Maternal-Foetal Medicine to provide expert opinions on more complicated pregnancies. Joint clinics with our specialist Rheumatologists are held on Mondays to look after women with conditions such as Systemic Lupus Erythematosus (SLE) and Antiphospholipid Syndrome (APS). Our obstetricians have close liaison with the other specialists in our hospital such as Cardiologists and Haematologists. This close communication allows closer monitoring of the patient’s condition and excellent care to be provided.

Women with the following medical conditions are looked after in our High Risk Pregnancy Clinic. (The list is not exclusive)

1. Hypertension (pre-existing hypertension or pregnancy-induced hypertension)
    

2. Rheumatological conditions such as SLE and APS
    

3. Cardiac conditions (congenital or acquired)
    

4. Respiratory disorders such as Asthma
    

5. Thyroid disorders
    

6. Blood disorders such as low platelet count
    

7. Bad obstetric history such as previous recurrent miscarriages
    

8. Pregnancies with Intra-uterine Growth Restriction (IUGR)
    

9. Pregnancies with abnormally sited placenta / low placenta
    

10. History of threatened preterm labour
     

Diabetic Clinic

This clinic is currently held once a week. The clinics are run by senior consultants in the Division of Maternal-Foetal Medicine with a special interest and expertise in this field. All patients with pre-existing diabetes and gestational diabetes (diabetes detected during pregnancy) are reviewed in this clinic. Endocrinologists provide their expertise in looking after our patients with diabetes. Dietitians and specialist diabetic nurses are on site to provide a comprehensive range of services including advice regarding the diet, testing of patient’s own blood sugar levels and the use of insulin if necessary. To minimize inconvenience, services are provided to allow patients to phone or fax their blood sugar results to our specialist nurses to be reviewed by our doctors.