OBSTETRICS

2.-Gynaecology

United Medical specialises in a complete women’s healthcare service. Understanding and compassion, matched with highly developed skills and knowledge, makes us a truly distinguished practice.

Understanding Pregnancy

While each pregnancy is exciting, it is also unpredictable and every woman wants the best outcome when it comes managing it. At United Medical, we aim to provide and share information that guides you through your pregnancy journey, leaving you more prepared to enjoy your pregnancy to the utmost.

Our Philosophy of Care

At United Medical in Singapore, we will be with you at every exciting step of your momentous journey to parenthood. From the moment you start down the road to bringing new life into the world, we provide only the best care while doing our utmost to minimise stress for you and your loved ones.

 

We will work with you to provide antenatal care and delivery & postnatal care performed by our experienced and passionate Dr Liana Koe.  We believe that we are all in this together and will guide and support you through every step of your journey to parenthood.

Eight reasons to choose United Medical:
  1. United Medical, a one-stop women’s clinic, specializes in Obstetrics & Gynaecology

Our specialist clinic understands the needs & expectations of local & foreign patients:

10 Sinaran Drive, #11-05 Novena Medical Centre, Singapore 307506.

1. United Medical Clinic Location Image
  1. Comprehensive suite of Obstetrics & Gynaecology services

We provide a comprehensive suite of Antenatal Care and Delivery & Postnatal Care services. You will be served seamlessly and pampered with quality care.

 

  1. Antenatal Care package

(01)  From 16 weeks gestation onwards

Up to 11 office-hour visits until EDD with routine tests only

(02) From 10 weeks gestation onwards

Up to 13 office-hour visits until EDD with routine tests only

For more information, please click: Our Packages

 

  1. We empower You

By providing comprehensive information and education throughout the process, you will be better-equipped to understand the various treatment options, thereby putting your mind at ease.

 

  1. We aim to provide a stress-free experience

Being parents ourselves, we understand fully the anxiety that can accompany the journey to parenthood. Hence, we do our best to minimise stress by taking a holistic and maternal approach to care.

 

  1. Personalised Support & Care

We work closely with you to offer personalised delivery support. From the beginning of the journey, we will map out together with you a unique baby delivery plan to fit your schedule and address any medical and emotional challenges along the way.

 

  1. Flexibility

As every lady is unique, we are able to tailor treatments to suit your very own delivery needs and requirements.

 

8. Team Excellence

Our nurses and administrative staff possess a wealth of experience. We take pride in offering the latest knowledge in the field of antenatal care and delivery & postnatal care. For enquiries or appointment bookings, please do not hesitate to contact our staff.

2.2-FIRST-TRIMESTER
FIRST TRIMESTER OF PREGNANCY

One of the most common concerns of parents-to-be is whether the unborn child is going to be affected by chromosomal or birth defects. First trimester – Birth defects occur in around 3% of babies and chromosomal defects are present in 0.5% of pregnancies. The chance of a pregnancy carrying such a defect can be assessed as early as the first trimester, in the form of the first trimester screening (otherwise known as one-stop clinic for assessment of risk, OSCAR) test. This is a non-invasive assessment, comprising of a blood test for the mother and a scan of the fetus. The resulting risk score will allow the parents-to-be and the obstetrician to plan ahead for the outcome of the healthy pregnancy. All expectant mother are encouraged to have the test done, regardless of age.

EARLY PREGNANCY SYMPTOMS

Did you have a missed period based on your calculations of a pregnancy calendar? Early pregnancy symptoms help you detect pregnancy a few days after conception. Many of these symptoms are subtle and can be confused for other problems. However, if you have more than one of the early pregnancy symptoms, then most probably you have conceived.

These signs help you understand your changing body and the growth of the baby inside you.

 

Here are some early pregnancy symptoms:

  • Missed Period. Though a very prominent early pregnancy symptom, a missed period can have many causes. By the time you have confirmed the period was delayed by pregnancy, you are already a few weeks into it.
  • Nausea. Morning sickness can take you by surprise any time of the day. You feel queasy all of a sudden. Many women are unable to eat spicy or greasy food because of this symptom. One of the ways to deal with this is to eat light, eat smaller meals and keep your surroundings cool.
  • Sensitive breasts. Tender breasts are another problem for pregnant women. Apart from tenderness, you may also notice swelling of the breasts. Veins along the sides of the chest become more prominent. The color of the areola darkens.
  • Spotting is known as “implantation bleeding” in medical terms. Implantation bleeding happens a few days after conception, when the embryo implants itself on the uterus wall. This is where it will stay and develop in the next nine months.
  • Cramps. Along with implantation bleeding, you might also experience cramps. Cramping is another early pregnancy symptom that alerts you to conception. It is like the cramps you feel during your period. If the cramps are severe, consult your doctor immediately.
  • Tiredness. You may feel tired all the time. Fatigue is one of the more subtle early pregnancy symptoms. Be careful of ignoring the signals your body is sending you to take it easy. Cut down on your workload and take plenty of rest.

 

If you have one or more of the early pregnancy symptoms, you should consult our obstetricians.

EARLY PREGNANCY SCREENING

The First Trimester Screen is a new, optional non-invasive evaluation that combines a maternal blood screening test with an ultrasound evaluation of the fetus to identify risk for specific chromosomal abnormalities, including Down Syndrome Trisomy-21and Trisomy-18.

 

In addition to women’s health care, in screening for these abnormalities, a portion of the test (known as the nuchal translucency) can assist in identifying other significant fetal abnormalities, such as cardiac disorders.  The screening test does not detect neural tube defects.

PREGNANCY DATING SCAN

All pregnant women are offered an ultrasound scan at around 8 to 14 weeks of pregnancy. This is called the dating scan. It’s used to see how far along in your pregnancy you are and check your baby’s development.

 

Our obstetricians will book you a dating scan appointment. It will usually take place at our specialist clinic.

 

You may need to have a full bladder for this scan, as this makes the 4D ultrasound image clearer. You can ask our staff before the scan if this is the case. The dating scan usually takes about 20 minutes.

 

What is the purpose of the dating scan?

The purpose of the dating scan is to check:

  • how many weeks pregnant you are and work out your due date (the estimated date of delivery, or EDD)
  • whether you’re expecting more than one baby
  • that the baby is growing in the right place
  • your baby’s development
  • Some abnormalities may also be detected at this scan, such as neural tube defects (spina bifida is a type of neural tube defect)
CONTEMPORARY DOWN SYNDROME SCREENING

The vast majority of babies are normal. However, all expectant mothers have a small risk (about 2%) of delivering a baby with a major physical and / or mental handicap. This may be due to a chromosomal abnormality, genetic disease or structural abnormality in the baby. The commonest chromosomal abnormality is Down Syndrome.

 

Down Syndrome occurs in 1 out of every 700 babies born. It causes learning difficulties and, in many instances, multiple medical problems. All pregnancies, regardless of a woman’s age, are at risk for Down Syndrome.

 

Some couples may choose to be tested for Down Syndrome as such information may help them prepare psychologically for the birth of a handicapped child or reach a decision about whether or not to continue with the pregnancy.

 

Other couples may choose not to be tested for Down Syndrome, especially if they have decided to keep their pregnancy regardless.

 

Although invasive diagnostic testing through Chorionic Villus Sampling/Amniocentesis is the only way to know if the fetus has a chromosomal abnormality. Such procedures are associated with a risk of miscarriage (0.3%).

 

Screening tests are instead available to better estimate the risk of Down Syndrome in each pregnancy. The result of the screening test may help couples to decide if they want to pursue invasive testing.

WHY IS FOLATE IMPORTANT?

Folate is a B vitamin crucial in the development of baby’s nervous system. It has been shown to reduce the chance of having a baby with a neural tube defect (a disability affecting the nervous system). Folate is easily destroyed during cooking and large servings are necessary for adequate intake.

 

The simplest way is to take a folate supplement (one 5 mg tablet daily) for the first 12 weeks of pregnancy. Folate is particularly important if you suffer from epilepsy, thalassaemia or have a family history of having relatives with a neural tube defect.

United Medical Packages:

Full-suite Pregnancy Delivery Process >> check out our packages here.

2.3-SECOND-TRIMESTER
SECOND TRIMESTER

As the pregnancy advances, a detailed ultrasound scan can be performed in the second trimester to check for structural defects within the baby, as well as markers of chromosomal problems. This is commonly performed between 18 to 20 weeks gestation, to allow time for decision making and intervention. However, the limitations of such scans have to be accepted as minor defects may still be missed, despite the best of operators.

2.4-THIRD-TRIMESTER
THIRD TRIMESTER

When the pregnancy reaches the third trimester, the focus shifts towards the baby’s growth and planning for delivery. A scan of the growth parameters in the third trimester will allow us to check on babies that are growing too quickly or too slowly. This will allow parents-to-be and their obstetrician to plan for the delivery (timing and route). Mothers who are at risk of gestational diabetes may also be offered the diabetes test in the third trimester

DELIVERY

Most pregnancies will conclude with a vaginal delivery while others will have a caesaarean section planned from the early antenatal period. This may be caused by specific conditions that make vaginal delivery inappropriate, such as low-lying placenta, breech presentation, etc.. Others may attempt a vaginal delivery, but end up with a caesarean section when labour does not progress or is unsafe to allow further progress. In selected cases, assistance may be offered for vaginal delivery, in the form of forceps or vacuum, only when deemed appropriate by the obstetrician.

2.6-POSTNATAL-CARE
POSTNATAL CARE

After delivery, the mother’s body undergoes dramatic changes to return to pre-pregnancy state and she has to deal with healing of delivery wounds, breastfeeding, care of the new-born, as well as the swinging hormone levels. The postnatal check-up will allow the obstetrician to assess the health status of the new mother and offer assistance to those in need. Routine gynaecology screening and contraception options will also be discussed.

Dr Liana Koe
Dr. Liana Koe

Obstetrician & Gynaecologist

Dr Liana Koe obtained her medical degree from the National University of Singapore, and trained in Obstetrics and Gynaecology (O&G) under the SingHealth cluster. She subsequently attained her specialist accreditation in Obstetrics and Gynaecology by the Singapore Accreditation Board (Ministry of Heath), is a member of the Royal College of Obstetrics and Gynaecology (UK), and a registered specialist with the Singapore Medical Council.

Dr Koe was a specialist at KK Women’s and Children’s Hospital. As an obstetrician, Dr Koe appreciates that pregnancy should be cared for holistically, with compassion and a listening ear, delivering the best possible medical care to create an enjoyable pregnancy journey for her patients.

Her philosophy as a doctor is to encourage patient empowerment while supporting patients’ choices, and is dedicated to serving her patients with respect and understanding.

 

For appointments and enquiries, please do not hesitate to contact us at: +65 69096236.

Dr Koe was active in clinical research as well, having presented research findings at local and international conferences, including Australia, Japan, South Africa, Austria, and France. In 2013, she received the SingHealth Duke-NUS O&G Academic Clinical Programme (ACP) Grant Award for her research on improving osteoporosis screening in menopausal women. Being passionate about the community, she also actively volunteers overseas on medical trips.

In addition, Dr Koe dedicated her time to nurture current and future generations of doctors as Physician Faculty for SingHealth O&G residents, and Course Director for Course for OB/Radiologists in Pelvic Ultra-Sonography (CORPUS). She was also a Clinical Teacher and Lecturer for the 3 medical schools in Singapore (Lee Kong Chian School of Medicine, Duke-NUS Medical School, and Yong Loo Lin School of Medicine).

Besides managing general gynaecological conditions such as fibroids and cysts, with proficiency in key-hole (laparoscopic) surgery, Dr Koe has a special interest in cervical cancer screening, colposcopy, and treatment of pre-invasive cervical disease, and is a member of the Society for Colposcopy & Cervical Pathology of Singapore (SCCPS).

‘One person caring about another represents life’s GREATEST value’

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