Dr Law Wei Seng

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Pregnancy Care Delivery Service

Pregnancy Care and Delivery

  • Antenatal checkups and screening for Down’s Syndrome and other fetal abnormalities
  • Useful advice to ensure a healthy pregnancy and to prepare mums-to-be physically and emotionally. This includes advice on diet, exercise, what to expect and ways to relieve symptoms of pregnancy, sex during pregnancy, and advice on pain management in labour
  • Provision of comprehensive and highly-specialized antenatal and perinatal care by our multidisciplinary team which includes a maternal-fetal specialist, neonatologist, paediatrician and anaesthetists.

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Week-By-Week Guide To Pregnancy

Each week of pregnancy will include a detailed description of your baby’s development and an explanation of the changes in your body.

First Trimester

The first week is your menstrual period. This week counts as part of the 40-week pregnancy, even though your baby has not been conceived yet. It is because your expected delivery date is calculated from the first day of your last menstrual period.

During this week, you are still not pregnant, but the lining of your uterus is developing to prepare itself to nourish your baby. Your body also secretes a follicle-stimulating hormone, which stimulates an egg to mature. This is when you are most likely to conceive. After your partner ejaculates, millions of sperm travel through the vagina. Only hundreds reach the fallopian tube, where the egg cell is waiting. Fertilisation takes place near the end of this week. You will be pregnant, but you won’t notice any changes in your body just yet.

Your baby was just conceived. The fertilised egg will undergo a process of cell division. About 30 hours after fertilisation, it splits into two cells, then four, eight, and continues to divide as it moves to the uterus. When it arrives, this group of cells will look like a tiny ball (morula). It becomes hollow and fills with fluid and is called blastocyst. It will then attach itself to the lining of the uterus. This process is called implantation. The lining of the uterus (endometrium) provides nutrients to the developing embryo and helps remove waste. This site will develop into the placenta over time.

Four weeks into your pregnancy, your baby is now an embryo and consists of two layers of cells. Eventually, these will develop into all of your baby’s organs and body parts. Two other structures will develop: the amniotic cavity and the yolk sac. The amniotic cavity is filled with amniotic fluid that will surround and protect the growing embryo. The yolk sac produces blood, helping nourish the embryo until the placenta takes over.

Some women may feel slight cramping and spotting during this week because the embryo buries itself deep within the endometrium. Once implanted, the embryo starts to generate a hormone called human chorionic gonadotropin (hCG), which helps to maintain the endometrium. This hormone also signals the ovary to stop releasing an egg monthly, stopping your monthly periods.

The embryo has been a clump of cells until now. But at this point, a distinct shape starts to form. The neural tube runs from the embryo’s top to the bottom, which will become your baby’s spinal cord and brain. A bulge in the centre of the embryo will develop into the heart. The placenta develops at this point. It is through the placenta and its finger like projections that the embryo gets nourishment from you.

Your baby’s brain and nervous system are quickly developing by week 6. Optic vesicles, which will form the eyes, and the passageways forming the inner ear start to develop on the sides of the head. Your baby’s heart will begin to beat and might be detected on ultrasound examination. The beginnings of your baby’s digestive and respiratory systems are forming, and small buds that will grow into arms and legs appear this week.

Babies are often measured from the top of the head to the bottom of the buttocks – not from head to toe. Making a full-length measurement is challenging because their legs are curled against the torso for most of the pregnancy. Your baby only measures two to five millimetres during this week.

The umbilical cord has formed and is your baby’s connection to you (oxygen, nourishment, and disposal of wastes). Its digestive tract and lungs continue to develop. The eyes, nostrils, mouth, and ears are some of the facial features that become more defined during this week. The tiny arm buds formed last week have hands on the end, which look like a little paddle.

Your baby’s fingers and toes are just starting to form. The arms can flex at the elbows and wrists, and the eyes are becoming more noticeable because they have begun to develop pigment (colour) in the retina. The intestines are also getting longer, not having enough room in the baby’s abdomen. So they stick out into the umbilical cord until week 12. By this time, the beginnings of the buds that will develop into genitals have appeared but have not yet developed enough to reveal your baby’s sex.

The tail at the bottom of the spinal cord has shrunk and almost disappeared by this week. Your baby’s head has also been growing and is quite large compared to the rest of the body. It curves onto the chest. Your baby measures about 16 to 18 millimetres and weighs around 3 grams.

The tip of the nose has already developed and is seen in profile. The flaps of skin over its eyes have started to shape into eyelids, which will be more noticeable in the next few weeks. The digestive system continues to develop, and internal reproductive features (testes and ovaries) begin to form this week. Your baby’s intestines are growing longer, and the anus is forming.

As the muscles develop, your baby may make some first movements. You won’t be able to feel them for a few more weeks, but they might be more visible if you have an ultrasound.

By this week, all vital organs have been formed and are beginning to work together. External changes happen, such as the disappearance of the tail and the separation of fingers. Internal developments also occur during this week, like tooth buds forming inside the mouth, and if you are having a boy, his testes will start producing the male hormone testosterone. Week 10 marks the end of the embryonic period. The embryo now has a distinctly human appearance. Your baby will officially be a foetus starting next week.

From week 11 to week 20, your baby will grow fast – increasing in size from about 5 cm to about 20 cm. The blood vessels in your placenta are also growing in size and number to give your baby more nutrients. Your baby’s head accounts for about half of the body length. The ears move toward their final position on the sides of the head. Even though its reproductive organs are developing quickly, the external genitals will only appear by the end of this week. They will be clearly distinguished by week 14.

Vocal cords are formed, and your baby’s kidneys are functional in the last week of the first trimester. After ingesting amniotic fluid, your baby can excrete it out of the body as urine. The intestines will also make their way into the abdomen because there is room for them now.

Second Trimester

Your placenta has already developed, providing your baby with nutrients, oxygen, and waste disposal. It also makes progesterone and oestrogen, hormones that help maintain the pregnancy. Your baby’s eyelids have fused to protect the eyes as they develop. He or she might be able to put a thumb in his or her mouth, although the sucking muscles are not fully developed yet.

Some fine hairs (lanugo) have grown on your baby’s face and will eventually cover most of your baby’s body until it has shed before delivery. The genitals have fully developed but may still be hard to see on an ultrasound. Your baby also begins to generate thyroid hormones because its thyroid gland has matured. Your baby weighs about 45 grams and is about 9 cm long from crown to rump.

Your baby’s skin has been continuously developing. It is so thin and translucent that the blood vessels are visible through it. Hair growth continues on the head and the eyebrows. The ears are almost in position, though they are still a bit low on the head. Your baby’s skeletal system and muscle development continue, and he or she is probably making movements with the mouth, head, arms, hands, wrists, legs, and feet.

He or she now weighs about 110 grams and measures about 12 cm from crown to rump. Your baby can hold its head up, and the development of facial muscles permits various expressions, such as frowning and squinting.

Your baby measures 13 cm and weighs 140 grams. The placenta is still growing to accommodate your growing baby. Now, it contains thousands of blood vessels that bring oxygen and nutrients from your body to your baby’s developing body.

This week, the ears have moved to their final position, standing out from the head. In the coming weeks, your baby will probably be able to hear. The middle ear’s bones and the brain’s nerve endings are developing, enabling your baby to hear sounds, such as your heartbeat and the blood moving through the umbilical cord.

Your baby’s eyes are now facing forward rather than to the sides, and its retinas may be able to detect a flashlight’s beam if you hold it to your abdomen. Your baby’s bones had been developing until now, but they were still soft. Starting this week, they start to harden or ossify. The bones in the clavicles and the legs are some of the first bones to solidify.

Your baby is covered with a white, waxy substance that helps prevent its delicate skin from being scratched or chapped. The development of brown fat happens this week, which will help keep your baby warm after birth. You might feel your baby’s first movements, usually between weeks 18 and 20. They may feel like a growling stomach or butterflies in your stomach.

At 20 weeks or halfway into your pregnancy, your baby weighs about 312 grams and measures about 16 cm from crown to rump. Your baby is also taking up increasing space in your womb. This continued growth will put pressure on your stomach, lungs, bladder, and kidneys. Under the white, waxy substance that covers your baby, the skin is thickening and developing layers. Hair and nails continue to grow. Your doctor may recommend that you receive an ultrasound scan to determine the size, position, and sex of the foetus and confirm normal anatomy (look for any structural abnormalities of bones and organs).

Almost all your baby’s nourishment still comes from you. Your baby’s spleen and liver have been responsible for producing blood cells until now. This week, the bone marrow spaces have developed enough to contribute to the formation of blood cells.

Your baby’s senses keep on developing daily. Taste buds have begun to form on the tongue. The brain and nerve endings have also formed enough, allowing the foetus to feel touch. Your baby may put this newfound sense to test by sucking on a thumb or stroking his or her face. He or she may as well feel other body parts and see how they move.

In boys, the testes have begun to move down from the abdomen. In girls, the ovaries and the uterus are in place, and the vagina has developed. So it can be said that your baby’s reproductive system progresses during this week.

Although fat is starting to build up on your baby’s body, the skin still hangs loosely, giving him or her a wrinkled appearance. Your baby’s workout routine includes regularly moving the muscles in the fingers, arms, toes, and legs. You may feel forceful movements as a result. Your baby weighs a little more than 454 grams.

The inner ear, which controls balance, is now fully developed. Thus, your baby might be able to tell when he or she is right side up or upside down while floating and moving in the amniotic fluid.

Glucose screening is an important prenatal test that is done between weeks 24 and 28. This screening test checks for gestational diabetes, a temporary type of diabetes during pregnancy that can cause problems to your newborn child, such as low blood sugar.

You may notice that your baby has alert and resting periods. More foetal activity can be noticed when you are still or relaxing. Also, he or she may be able to hear your voice because your baby’s hearing has continued to develop, too.

Your baby’s eyes will soon open and blink after being sealed shut for the last few months. Eyelashes and more hair on the head are growing in. Your baby weighs a little less than 907 grams and still looks wrinkly. However, he or she will continue to gain weight steadily over the next 14 weeks until birth.

Third Trimester

By this first week of the last trimester, your baby looks close to what he or she will look like after birth, just smaller and thinner. The liver, lungs, and immune system still need to develop fully. As your baby’s hearing continues to develop, he or she may start to recognise your voice and your partner’s. Your baby may hear the sounds as muffled because the ears are still covered with the white, waxy substance that protects the skin from becoming chapped.

Your baby weighs approximately 1 kilogram and measures about 25 cm from crown to rump. The folds and grooves of your baby’s brain are expanding and developing continuously. Additional layers of fat also form this week. At your next prenatal appointment, your doctor may tell you whether your baby is head-first or bottom-first (breech position) in the womb. If your baby is in the breech position, he or she still has two months to change position. Most babies switch positions on their own.

Your baby continues to be active. So you may experience hard jabs and punches. You may do a foetal kick count: your baby should move at least ten times in two hours.

Weighing about 1.4 kg and measuring about 27 cm from crown to rump, your baby continues to grow fat and gain weight. This fat makes him or her less wrinkly and will help give warmth after birth. To prepare for breathing after delivery, your baby will mimic breathing movements by repeatedly moving the diaphragm. He or she can even get hiccups, which you may feel as rhythmic twitching.

Your baby is peeing several cups of urine daily into the amniotic fluid. He or she is also swallowing and practising breathing amniotic fluid, which is replaced completely several times daily. Too much fluid in the amniotic sac could mean that the baby is not swallowing normally or that there is a gastrointestinal obstruction. Not enough fluid in the amniotic sac could mean your baby is not peeing correctly, which could indicate a problem with the urinary tract. As part of your routine ultrasound, your doctor will measure your amniotic fluid levels.

The hair on your baby’s head, as well as eyelashes and eyebrows, are evident. The fine hair that has covered your baby since the beginning of the second trimester is falling off, though some may remain on the shoulders and back after birth. At about 1.8 kilograms and 29 cm from crown to rump, your baby would have an excellent chance of survival if you delivered now.

Billions of neurons have developed in your baby’s brain to help him or her learn about the womb environment. Your baby can somewhat see, listen, and feel. The eyes can detect light, and the pupils can dilate or constrict in response. The lungs are almost fully developed. Fat will continue to build on his or her body for warmth and protection. Like a newborn, your baby sleeps most of the time and even has rapid eye movement (REM) sleep.

A developing baby absorbs calcium from the mother to make and harden bones. Ensure you are getting enough of this mineral to prevent calcium loss in your bones. Partner your prenatal vitamins with calcium-rich food like milk, yoghurt, cheese, tofu, broccoli, soybeans, almonds, spinach, and more.

By this time, most babies are in position for delivery. Babies born at 34 weeks typically have fairly well-developed lungs. Their average weight and size of 2.25 kilograms and 32 cm from crown to rump allow them to survive outside the uterus without extensive medical intervention.

This week marks your baby’s quickest period of weight gain – about 226 to 340 grams per week. Fat is deposited all over his or her body, especially around the shoulders. Your baby’s increasing size means that he or she is cramped and restricted inside the uterus. You may feel fewer but stronger movements. If your baby is in a head-first position, the head will rest on your pubic bone in preparation for labour.

Your baby is fast becoming a plump one – from a tiny wrinkly foetus you saw on previous ultrasound scans. Also, your baby’s fuller face is due to the fat on the cheeks and powerful sucking muscles. Your baby weighs approximately 2.72 kilograms. The bones that constitute your baby’s skull tend to move and overlap as it helps him or her pass through the birth canal.

Your baby has developed the coordination to grasp with his or her fingers. Your baby may turn toward it in your womb when flashed with a bright light. He or she continues to gain weight, approximately 14 grams a day.

Your baby weighs about 2.9 kilograms and measures about 34 cm from crown to rump. Fat is still building, although growth is much slower now. Your baby has been able to ingest amniotic fluid, so waste materials have built up in the intestines. Dead skin cells, fine hair, and cells shed from the intestines are some of the waste products in your baby’s first bowel movement. If you are having a boy, his testicles have dropped into the scrotum. If you are having a girl, the labia are now fully developed.

Most of the white, waxy substance that covered your baby’s skin, as well as the fine hair (lanugo) has disappeared. Your placenta has been supplying the baby with antibodies that will help his or her immune system fight infection for the first six to 12 months.

After long months of anticipation and preparation, your baby is here. Other moms do not deliver right on their estimated due dates. A baby born at 40 weeks weighs approximately 3.30 kilograms and measures about 51cm on average. Your baby’s skin may have discolorations, rashes, and dry patches. But this is all completely normal. After birth, your OBGYN will suction mucus out of your baby’s nose and mouth, and you will get to hear his or her first cry. A series of quick screening tests will assess his or her vital signs and responsiveness. Then, your baby will be physically weighed and measured.

Selecting a Gynaecologist

There are many important factors to keep in mind in choosing a gynaecologist. Firstly, you may ask your primary care provider for a referral list. Relatives and female friends may also give good recommendations. Inquire about the gynaecologists’s skills, experience and disposition.

You may also want to check out reviews and the gynaecologist’s credentials on doctor rating websites and on their practice’s website. Board certification is one of the most important considerations when choosing a gynaecologist. It shows that he or she has the necessary skills, training, and experience in providing gynaecologic care.

It is important that you feel comfortable with your gynaecologist and the hospital where you will be having the delivery, as it is important for the mother to have peace of mind.

How to know you are in labour

Learning the signs of labour before your due date could help you prepare for delivery. Signs include strong and regular contractions lasting about 30 to 70 seconds and coming about five to ten minutes apart, pain in your belly and lower back that does not go away when you move or change positions, a bloody mucus discharge (bloody show), and your bag of water breaking. If you experience these symptoms,  contact your OBGYN team immediately to help you understand what exactly is going on. Do not worry or feel embarrassed calling outside work hours.

What to expect during delivery

You will deliver your baby during the second stage of labour. It can take from about a few minutes to a couple of hours, but it might take longer for first-time mothers and women who have had an epidural. Your OBGYN will ask you to bear down during each contraction and tell you when to push. At some point, you may be asked to push more gently or not at all. Also, to get you motivated, you might be asked if you could feel the baby’s head between your legs. After the baby’s head is delivered, the rest of the body will follow shortly. His or her airway will be cleared if necessary.

During the last stage of labour, you will deliver the placenta in about 30 minutes to an hour. You will continue to experience close but less painful contractions. They help move the placenta to the vagina. You will be asked to push gently to deliver the placenta. Subsequently, your uterus will keep on contracting to return to its usual size.

What to expect after delivery

Your body changes a lot during pregnancy to keep your baby safe and healthy. After delivery, your body changes again. These include your breasts getting a supply of milk, belly cramps, vaginal discharge, and feeling extra stressed. Discomforts and changes to your body after childbirth is normal. But ensure they are not symptoms of a health problem that needs treatment by attending all your postpartum checkups. Postpartum care is essential to make sure you are recovering well from labour and birth and don’t develop serious health conditions.

Nursing health after delivery

You will undergo many changes throughout the postpartum period, both physically and emotionally. Additionally, you are learning how to handle all the adjustments that come with becoming a new mother. The postpartum period also allows you and your spouse to learn how to properly take care of your newborn and adjust to your new role as a family. You will need plenty of rest and good nutrition during the first couple of weeks.

Rest. Babies have different time clocks compared to adults. A newborn wakes up about every three hours to be changed, fed, and pacified. To help you get more rest, have someone else take care of responsibilities other than feeding your baby and taking care of yourself. Secondly, sleep when your baby sleeps. This may only be a few minutes, but it could significantly improve your recovery. Also, get outside for postpartum exercise. You should get at least 150 minutes of moderate-intensity aerobic activity per week. For example, you could have three 10-minute brisk walks every day. If you want a customised routine, consult your OBGYN if it is suitable for you.

Good nutrition. You need to eat a healthy and balanced diet after delivery so you can take care of yourself and your baby. Food group categories that are recommended are grains, vegetables, fruits, dairy, and protein. If you are breastfeeding, you should drink more fluids along with balanced meals. You may find yourself thirsty while your baby is nursing. Keep a jug of water and some healthy snacks close to you to avoid dehydration. Talk to your OBGYN or a dietitian to learn more about postpartum nutrition.

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