Tuesday, January 26, 2010

Cleft Lip and Cleft Palate (兔唇/兔颚)

It is the expectation of every pregnant mother to deliver a healthy and perfectly normal baby.
Unfortunately in real life, sometimes the baby is born with some degree of handicaps, such as cleft lip and cleft palate.

Cleft Lip (唇)

Cleft Palate (兔颚)

What is cleft Lip and cleft palate?

Cleft lip and palate is a inborn defect affecting 1 in 700 newborns.

It is caused by a split or separation in the structure of the lip or the roof of the mouth.
During early pregnancy, separate areas of the face develop and then join together. When some parts fail to come together, a cleft is formed.
Cleft lip and palate can happen together or separately.

How does it happen?

In Malaysia, it is estimated that one out of 700 babies is born with a cleft lip or palate.
The causes of cleft lip and/or palate are not understood very well.

Sometimes clefts run in families and sometimes a baby is born with a cleft without anyone else in the family having one.

One study has shown that mothers who smoke 20 or more cigarettes a day during pregnancy are more than twice as likely to have babies born with a cleft lip and/or palate than non-smokers.

The same study found that babies were eight times as likely to have a cleft lip and/or palate if they were genetically predisposed and if their mother smoked during her pregnancy.

How to detect cleft lip and cleft palate before delivery ?

A detailed ultrasound scan at 5 months of pregnancy is important to detect this defect.
4D ultrasound scan provides extra accuracy to pick up this inborn defect.
If the baby has cleft lip and cleft palate, a detailed scan to look for other associated abnormality is necessary because occasionally the baby may have more than one inborn defect.

4D Scan Image of Cleft Lip

What should I do if my baby has cleft lip and cleft palate?

It is not easy for the parents to accept the fact and it is also very difficult for the doctor to break the news to them if the baby is diagnosed to have this defect.
The parents usually need a lot of emotional support to face the reality.
Once the diagnosis of cleft lip/palate is confirmed after the delivery, the parents need to learn a proper feeding method to prevent milk aspiration. The baby needs a special feeding teak to prevent leaking of milk to the nose.
Cleft lip can be surgically repaired after the baby is 3 months old and the cleft palate is usually repaired after the baby is one year old.
With the modern plastic surgery techniques, the repairs can be done nicely without leaving obvious surgical scar.

Plastic surgery repair of cleft lip

Wednesday, January 20, 2010

H1N1 Vaccine ( H1N1 疫苗)

Anonymous said:

Hi Dr Jason

On Saturday when I went to see you for my regular prenatal check-up, I have forgotten to ask you regarding the H1N1 vaccinations which will be made available soon by the Government clinics to all high risk groups, including pregnant wormen. The question is, is it safe to take up the vaccinations and are there any side effects to the fetus if taken. I am now at my 24 week of pregnancy.


Hi, Annonymous,

The outbreak of H1N1 infection is generally under controlled in the Northern Malaysia. For the past 3 months, there was no new case reported in my hospital.
H1N1 vaccine is relative safe in pregnancy as the vaccine is derived from genetic recombinant material, rather than from the material of the killed virus. Therefore, H1N1 vaccination during pregnancy is acceptable practice.
Unfortunately, the vaccine is still unavailable in Bagan Specialist and most of the private hospitals because the supply is limited.
Generally, H1N1 infection will only produce mild flu for majority of the infected pregnant mothers. Most of the H1N1 infections are self limiting without causing serious complication.
I had 2 patients who were infected during pregnancy period. Both of them had delivered their babies without any handicap or complication.

Despite claiming that this vaccine is safe during pregnancy, special precaution should be taken since this vaccine is still new in the market. There is no medical study to prove its long term safety.

As far as your job doesn't require you to travel, H1N1 vaccination during pregnancy is NOT compulsory.

Dr Jason

Thursday, January 14, 2010

声称服私人医院药物后下体流血 胎死腹中产妇讨公道


















It is very unfortunate for this disaster to happen. My sincere condolence to this lady.

However, I suspect the cause of death of her baby might not related to the antibiotics.

The symptoms described are more consistent with placenta abruption, a serious medical emergency that usually happen to the pregnant lady who has high blood pressure during pregnancy.

Placenta abruption is due to sudden placenta bleeding inside the womb, causing the blood clots formation behind the placenta bed.

Diagram on the Left : Normal placenta.

Diagram on the Right : A bleeding placenta with blood clots behind the placenta bed.

This condition usually happens among the pregnant ladies who have high blood pressure during pregnancy and insufficient vitamin B and folic acid.

This condition is serious and maybe life threatening to the baby.

So far there is no association between antibiotics usage and placenta abruption.

Wednesday, January 13, 2010

Boom in C-section births

HANOI - NEARLY half of all births in China are delivered by cesarean section, the world's highest rate, according to a survey by the World Health Organisation - a shift toward modernisation that isn't necessarily a good thing.

The boom in unnecessary surgeries is jeopardising women's health, the UN health agency warned in the report published online on Tuesday in the medical journal The Lancet.

Unnecessary C-sections are costlier than natural births and raise the risk of complications for the mother, said the report surveying nine Asian nations. It noted C-sections have reached 'epidemic proportions' in many countries worldwide.

The most dramatic findings were in China, where 46 per cent of births reviewed were C-sections - a quarter of them not medically necessary, the report said.

The WHO, which reviewed nearly 110,000 births across Asia in 2007-2008, found 27 per cent were done under the knife. That mirrors similar results reported by WHO in 2005 from Latin America, where 35 per cent of pregnant women surveyed were delivering by C-section.

In the US, where C-sections are at an all-time high of 31 per cent, the surgery is often performed on older expectant mothers, during multiple births or simply because patients request it or doctors fear malpractice lawsuits. A government panel warned against elective C-sections in 2006.

Monday, January 11, 2010

Infrared Episiotomy Home Care (红外线灯)


After a successful normal delivery, you need to learn to take care of your episiotomy wound.

There are 2 effective methods to assist episiotomy wound healing :

1) Sitz bath by soaking your wound into a warm salt water.
Soaking in warm salt water

Specially-designed basin to assist sitz bath

2) Infrared lamp to shine to the episiotomy wound to reduce pain and swelling.
Infrared Lamp

The infrared treatment is available in the hospital and the treatment will start 6 hours after the normal delivery.
Unfortunately, most of you can’t continue the treatment after you discharge from the hospital.

In order to provide convenient infrared home treatment, you can borrow a unit of infrared lamp from my clinic before you discharge from the hospital so that you can continue the infrared treatment at home for 1 week.

You need to return the infrared lamp to my clinic on your first follow-up.

Instruction to use Infrared treament:

1) You need to shine the infrared 2 times perday.

2) The duration of of treatment is 15 minutes in each session.

3) The distance between the infrared lamp and your episiotomy wound is about 45 cm.

Please handle my infrared lamp with care as no additional charge is imposed for this service.

Wednesday, January 6, 2010

Antenatal Class: A Journey Towards Parenthood.

Antenatal Class : A Journey Towards Parenthood

Venue : Safira Country Club

Date : 28/3/2010

Time: 1.30pm till 6.30pm

Registration Fee : RM 10.00

Map :

The Event Programmes:




Open ceremony by invited VIP


" A Journey Towards Parenthood"

Dr Jason Ong

Obstetrician & Gynaecologist

Bagan Specialist Centre


Kindergarden Children Performance

Tea Break


" Jaundice in Newborn"

Dr Teh Kin Hock


Bagan Specialist Centre


Massage techniques in the Newborn


Optimal Nutrition During Pregnancy

Ms Ng Wei Wei

Regional Nutritionist

Dumex Malaysia


Antenatal Exercise and Physiotherapy

Ms Chew


Q&A for the Panel Speakers

Closing Ceremony

The registration is only limited to 400 participants based on first come first serve basis.