Obstetrics

Caring for your pregnancy.

In a pregnancy, it is important to ensure that your pregnancy is healthy.

In the first 12 weeks of pregnancy (1^st trimester), scans are important to confirm the viability and location within the womb. Repeat scans are important to determine the estimated due date and identify any multiple pregnancies.

A fetal abnormality scan at 18-21 weeks of gestation will be scheduled to confirm whether your baby is developing normally

In the final trimester, your baby will be monitored closely for growth and you will be screened for gestational diabetes.

There will be a discussion on the delivery options and your doctor will keep track of your pregnancy progress and offer assistance.

Is the care for my IVF pregnancy any different?

Although most of these pregnancies are uncomplicated, in vitro fertilization can be associated with an increased risk for adverse perinatal outcomes primarily caused by the increased risks of prematurity and low birthweight associated with in vitro fertilization pregnancies.

Furthermore, IVF patients tend to be in the older age group and may have had previous pelvic surgeries for gynaecological conditions, putting them at an increased risk in their pregnancies.

Their anxiety levels are also understandably heightened and may need constant reassuring throughout this journey.

In selected cases, low dose aspirin may be started before 16 weeks of pregnancy to reduce the risks of high blood pressure related issues or fetal growth problems in later gestations.

A discussion on Down syndrome or chromosomal screening between 11- 14 weeks pregnancy is essential as patients tend to be older.

Our IVF patients are generally at risk of preterm deliveries since some of them may have pre-existing gynaecological conditions or surgeries performed in the past. Visualization of the cervix at the 18 to 22 weeks of gestation anatomy assessment with either a transabdominal or transvaginal approach may be performed to assess the risk of preterm delivery.

An assessment of fetal growth should be performed in the third trimester for pregnancies achieved with in vitro fertilization.

There is an increased chance of operative deliveries such as the use of instrumental vaginal deliveries or caesarean deliveries. Given the potential increased risk for stillbirth, there may be weekly antenatal visits beginning at 36 weeks of pregnancy.

There is no robust evidence on when is the best time to deliver an IVF pregnancy, hence we recommend shared decision-making on considering options for delivery before the due date.