Thursday, July 29, 2010

Risks for Preterm Births May Be Higher Among Overweight Mothers

July 28, 2010 — Risks for preterm births may be higher among overweight and obese mothers, according to the results of a systematic review and meta-analyses reported in the July 20 issue of the BMJ.

Compared with normal-weight women, very obese women were at 70% greater risk for induced preterm birth before 37 weeks and at 82% greater risk for early preterm birth (before 32 or 33 weeks).

"Overweight and obese women have increased risks of preterm birth and induced preterm birth and, after accounting for publication bias, appeared to have increased risks of preterm birth overall," the study authors write. "The beneficial effects of maternal overweight and obesity on low birth weight were greater in developing countries and disappeared after accounting for publication bias."

"Future research is needed to try to determine why overweight and obese women are at risk of preterm birth, and to determine effective methods of weight loss in women of childbearing age before pregnancy," the study authors conclude. " ...Clinicians need to be aware that overweight or obesity in women is not protective against having infants of low birth weight and should consider surveillance when indicated. Ideally, overweight or obese women should have prepregnancy counselling so that they are informed of their perinatal risks and can try to optimise their weight before pregnancy."


Personal advices :

1) Achieve an ideal body weight before pregnant. The ideal body weight should be between BMI 20 to 24.

2) Control your weight gain during pregnancy. The ideal weight gain during pregnancy is between 10kg to 15kg.

Tuesday, July 27, 2010

Some Caffeine Is Okay During Pregnancy

By Genevra Pittman

NEW YORK (Reuters Health) Jul 21 - A cup of coffee a day during pregnancy probably won't increase a woman's risk of miscarriage or premature birth, The American College of Obstetricians and Gynecologists said today.

Until recently, studies have had conflicting findings about the effect of moderate caffeine consumption on pregnancy complications.

But, "I think it's time to comfortably say that it's okay to have a cup of coffee during pregnancy," Dr. William Barth, the chair of a College committee which reviewed the evidence, told Reuters Health.

In a statement published online today in Obstetrics & Gynecology, the College's Committee on Obstetric Practice said that 200 mg of caffeine a day, about the amount in a 12-ounce cup of coffee, doesn't significantly contribute to miscarriages or premature births. That definition of "moderate caffeine consumption" would also include drinking about four 8-ounce cups of tea or more than five 12-ounce cans of soda a day, or eating six or seven dark chocolate bars.

The committee said the evidence was not clear on whether consuming more than 200 mg of caffeine a day might increase pregnancy risks.

Wednesday, July 21, 2010

Anti Tetanus Injection

Dear Dr,

I am currently pregnancy at 7 months. I followed up my pregnancy in the government clinic and also in the private hospital. This week, the nurse in government clinic gave me an injection for Anti Tetanus and another injection will be given next month.
But my gynae doctor in the private hospital said the injection is not necessary. May I know what is the purpose for the injection?


Hi, CL,

Tetanus (破伤风) is an infection of the wound, particularly the dirty wound. For example if your hand is cut by a sharp object, the doctor usually will clean the wound with antiseptic and then routinely they will give you an anti tetanus injection.

After delivery, you will have an episiotomy wound in your private part. The purpose of this injection is to reduce the possibility of the tetanus infection in your episiotomy wound.

About 50 years ago, there were not many hospitals available in the country. Many pregnant mothers had to deliver their baby at home by using the traditional midwifes service. These midwife carried a bag of scissors and knife to the house and conduct the delivery in a not cleaned and hygienic environment. Some of the scissors may contain bacterias because they were not cleaned and aseptic.

After delivery, many mothers developed wound infection in the episiotomy part and some of them complicated by serious tetanus infection.

As a result, all the pregnant ladies during that time need to receive anti Tetanus injection before the delivery to prevent wound infection.

However, this injection is not compulsory any more nowaday if you decide to deliver your baby in the hospital setting. The instruments in the hospital are properly cleaned and aseptic. Some of the instruments like needle, blade and suture are disposable. They are used once only before throwing away. So the risk of wound infection is very low.

This anti tetanus injection may cause fever, muscle pain and allergic reaction. For these reasons most of the private gynaecologist have stopped giving this injection.

However, the government clinic still continue to give the injection until today to every pregnant mothers, because some of them still prefer to deliver at home by the traditional midwifes, especially those stay in the rural kampung, Sabah, Sarawak and the Orang Asli.

So, CL, I agree with your gynae doctor that this injection is not important as far as you deliver your baby in the hospital setting.

Thursday, July 8, 2010

Some news to share.

龙凤胎早夭 伤心外婆申诉:护士叫我


二零一零年七月七日 下午五时四十三分








羊胎水破 当时怀胎5个月




没人接生 独自产下2婴







投诉医院无下文 郭庭恺促卫生部关注



看着婴儿衣 伤心妈妈红了眼眶






■ 黄秀菁和沈咪咪母女在郭庭恺的陪同下,向媒体申诉她的悲惨遭遇。

■ 黄秀菁表示不满值班护士告诉她给女儿自己生。

■ 沈咪咪提及她一对夭折的双胞胎时数度流泪。

■ 望着这些暂时派不上场的婴儿用品,咪咪不禁悲从中来,眼眶泛红。

■ 如宝宝穿上这可爱的小鞋子,小脚丫显得更活泼可爱。

■ 这套崭新的婴儿衣物,是亲戚赠送大儿子,但从未拆开过,咪咪打算留给即将诞生的宝宝。

Placenta Previa (前置胎盘)

Hi Dr Jason,
thank you for creating a informative blog to share with all of us.
Im 16 weeks pregnant at the age of 34. this is my 2nd pregnancy after 4 years. My eldest daughter was a C-section baby due to low lying placenta.
I just wonder for this 2nd pregnancy, will I bear the same risk of this kind of complication?
thank you
best regards



Diagram on the left : A normal placental location

Diagram on the right : Placenta previa where the cervix is fully covered by the placenta.

Hi, Lim,

Placenta previa is caused by abnormal placenta implantation into the lower part of the uterus where the cervix is completely or partially covered by the placenta tissue.

This situation is dangerous as the baby is unable to go through the birth channel due to the placenta obstruction at the cervix.
Sometimes, it may cause heavy bleeding during pregnancy and potentially risky to both the mother and baby.

The risk of recurrence of placenta previa in the subsequent pregnancy is around 20 percent.
It means you stand a high risk for this problem to happen again.

To make thing worse, a recurrent placenta previa with a previous caesarean delivery will significantly increase the risk of placenta accreta.

Placenta accreta is referred to a condition where the wall of uterus is infiltrated by the placenta tissue, particularly the wall around your surgical site in uterus.

The placenta issue may invade the uterine wall and as a result the placenta tissue is unable to separate from the uterus after delivery.

If this situation happens, it will cause heavy bleeding after delivery and sometimes the doctor need to remove the uterus in order to save life.

Your doctor should be able to determine the early placenta location after 3 months of pregnancy. If after seven months of pregnancy the location remained low lying, then the placenta previa is confirmed.

Dr Jason Ong