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SMG Women's Health Event Highlight

On 26 October, we joined SuperMom, Singapore’s largest parenting community to share more with new parents on some secrets to a successful pregnancy and babycare.

Dr Watt from The Obstetrics and Gynaecology Centre shared more about the 2nd Trimester, understanding your scans and planning your delivery/labour options available.

Tips on what happens during the second trimester

For many mummies, going into the second trimester often brings a sigh of relief and is the most enjoyable stage during pregnancy. The pregnancy typically becomes more stable as the hormonal levels fluctuate less. Depending on the advice of the obstetrician, some couples also take this time to go overseas before welcoming their little ones.

What to expect during the second trimester:

  • Hormones start to balance
  • Morning sickness starts to cease
  • Tiredness and tenderness in the breast usually eases
  • Appetite increases & weight gain
  • More prominent baby bump
  • Skin stretches, causing stretch marks and some itchiness
  • Pigmentation on the belly and on the face
  • Inflamed gums
  • Constipation as the womb starts to grow
  • Milk discharge from nipples as the breast prepares for breastfeeding
  • Increased nasal congestion and nose bleeds

Screening of chromosomal abnormalities & diagnostic tests during the second trimester

During the second trimester, obstetricians will perform multiple scans and test to ensure that the baby is doing well. They will perform the following:

  • Screening for chromosomal abnormalities
  • Diagnostics tests
  • Pre-eclampsia screening
  • Ultrasound scans for fetal anomaly.

During 11-14 weeks, obstetricians will screen for chromosomal abnormalities. These chromosomal abnormalities include Down syndrome (T21), Edwards Syndrome (T18) and Patou’s syndrome (T13). Screening for these abnormalities are first done through a Nuchal Translucency Scan, followed by a either an OSCAR test or Non-invasive Prenatal Test (NIPT), depending on the recommendation of the doctor. Read more about antenatal tests here.

Dr Watt thoroughly highlights that screening for chromosomal abnormalities can be inaccurate at times and that mums should consult their obstetricians on exploring further diagnostic tests.

Pre-eclampsia screening

Pre-eclampsia affects a large number of women and babies, and can be serious if untreated. It is a disorder that is related to high blood pressure and is often screened during 11-13 weeks. Early detection through screening tests can also help to significantly reduce the incidence of pre-eclampsia.

Ultrasound scans

As ultrasound scans are part of every mother’s routine checkup with their obstetricians, it is also a way to detect possible defects such as:

  • Neural tube defects
  • Chromosomal abnormalities
  • Congenital heart defects
  • Gastrointestinal & kidney defects
  • Cleft lip or palate
  • Birth Defects of the limbs

Upon diagnosis, obstetricians will recommend options such as counselling, further tests, termination of pregnancy or involve a paediatrician (for after birth).

For those who are in their 3rd trimester and preparing for delivery, know your options.

For those who are in their third trimester and preparing for delivery, Dr Watt shared more about the types of deliveries, Pros and Cons of each method and what to expect in labour.

Types of delivery methods that Dr Watt shared about includes:

  • Natural birth
  • Assisted vaginal birth (Either forceps or Ventouse)
  • Caesarean section (C-section)
Delivery Method
Pros
Cons
Natural Birth
  • More “natural”
  • Pain relief available during labour
  • Less pain & faster recovery post delivery
  • Safer for mothers – avoiding the risks of major surgery
  • Less breathing problems and better immune system for the baby
  • Lots of uncertainties of when labour will occur
  • Episiotomy might be required
  • Experience pain (pain relief available)
  • Fetal distress
  • Trauma to the tissue around birth canal
  • Risk of heavy bleeding
  • Risk of infection, urinary & Bowel incontinence
Assisted vaginal birth (Either forceps or Ventouse)
Usually performed when the baby needs to be delivered quickly and within the right conditions
  • Must satisfy several criteria:
    • The cervix must be fully dilated
    • The baby’s head must be low enough
    • The mommy must be able to push
  • Avoids risk of major surgery and deliver baby faster than C-section
  • Temporary forceps marks, bruising, abrasions
  • Higher risk of trauma to the birth canal & pelvic floor
  • Risk of fetal injury
Caesarean section (C-section)
Two types:
Elective – planned C-section
Emergency – unplanned C-section
  • Planned delivery is possible
  • Less disruption if planned
  • Less damage to pelvic floor
  • Lower risk of fetal distress
  • Lower risk of birth trauma
  • More pain
  • Longer recovery
  • Higher risk for mother as C-section is a major surgery
  • Risk of bleeding & injury to other organs
  • Risk of infections & blood clots that are potentially life threatening
  • Risk of adhesions, keloid & hypertrophic scar
  • Impact the next pregnancy
  • Higher risk of asthma/allergies for the baby
Delivery Method
Pros
Cons
Natural Birth
  • More “natural”
  • Pain relief available during labour
  • Less pain & faster recovery post delivery
  • Safer for mothers – avoiding the risks of major surgery
  • Lesser breathing problems and better immune system for the baby
  • Lots of uncertainties of when the labour will occur
  • Episiotomy might be required
  • Experience pain (pain relief available)
  • Fetal distress
  • Trauma to the tissue around birth canal
  • Risk of heavy bleeding
  • Risk of infection, urinary & Bowel incontinence
Assisted vaginal birth
(Either forceps
or Ventouse)
Usually performed
when the baby needs
to be delivered
quickly and within
the right conditions
  • Must satisfy several criteria:
    • The cervix must be fully dilated
    • The baby’s head must be low enough
    • The mommy must be able to push
  • Avoids risk of major surgery and deliver baby faster than C-section
  • Temporary forceps marks, bruising, abrasions
  • Higher risk of trauma to the birth canal & pelvic floor
  • Risk of fetal injury
Caesarean section
(C-section)
Two types:
Elective – planned
C-section
Emergency – unplanned
C-section
  • Planned delivery is possible
  • Less disruption if planned
  • Less damage to pelvic floor
  • Lower risk of fetal distress
  • Lower risk of birth trauma
  • More pain
  • Longer recovery
  • Higher risk for mother as C-section is a major surgery
  • Risk of bleeding & injury to other organs
  • Risk of infections & blood clots that are potentially life threatening
  • Risk of adhesions, keloid & hypertrophic scar
  • Impact the next pregnancy
  • Higher risk of asthma/allergies for the baby

With the different types of delivery methods, Dr Watt highly advise those who have uncomplicated pregnancies to go with vaginal delivery. However, for mummies with a preference for C-sections, obstetricians will respect your wishes. In special circumstances such as maternal conditions (i.e. pre-eclampsia) and fetal distress,vaginal delivery might not be suitable and should not be attempted.

Dr Watt also highlights that mummies should also monitor their due dates and work with their doctors as it might impact their method of delivery.

This is brought to you by our SMG WH editorial team.

Incorporated in 2005, Singapore Medical Group (SMG) is a healthcare organisation with a network of private specialist providers across four established pillars - Aesthetics, Diagnostic Imaging & Screening, Oncology and Women's & Children's Health. Within Singapore, SMG has more than 40 clinics strategically located in central Singapore and heartland estates. Beyond Singapore, SMG also has an established presence in Indonesia, Vietnam and Australia. Learn about our privacy policy here.

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