CA125 is a blood test to detect a protein substance in the blood of women with ovarian cancer (tumor marker test). This test is not specific as patients with non-cancerous conditions such as endometriosis and pelvic infection may also have the high protein substance in the blood. For more details, please read separate page on ovarian cysts.

Caesarean section is considered relatively safe. However, mother who delivers by cesarean has a higher risk of complications and a longer recovery period than with a routine vaginal birth. Such risks in Singapore are minimal and not common. Possible complications include:

Wound infection

Womb infection

Heavy blood loss

Heart or lung (cardiopulmonary) complications from anesthesia

Blood clot in the veins of the legs and lungs (thromboembolism)

Injury to the baby as well as mother such as bowel and bladder injuries

If the woman becomes pregnant again, she has some risk of the scar tearing open during labor (uterine rupture)

Click here to read more about Caesarean section.

Caesarean section, or C-section, is the delivery of baby through a cut in the mother's tummy (abdomen) and womb.
Caesarean sections are usually performed when a quick delivery is needed to ensure the mother's and infant's well-being. Common reasons for performing emergency C-section are:

Baby is showing signs of distress (fetal distress), such as passing motion (meconium) in the womb or baby's heart rates are irregular or falling on monitoring by electronic device (cardiotocograph)

Slow and difficult labor (dystocia)

Mother has hypertension

Placenta suddenly detached with heavy bleeding

When a known pregnancy problem or risk factor makes vaginal birth unsafe, a caesarean section is planned ahead of time (elective caesarean section). Examples include:

Baby in an abnormal position (lying horizontally instead of head-down position)

Placenta that is blocking the cervix (placenta previa)

Mother has severe high blood pressure (preeclampsia)

Narrow pelvis and a large fetus (cephalopelvic disproportion)

Click here to read more about Caesarean section.

Endocervical polyp, also called cervical polyp is a growth of tissue in the neck of the womb (cervix). Women of any age may have cervical polyp. It is very rarely cancerous. However, one cannot be sure unless it is removed and examined under microscope.
Most cervical polyp is discovered during routine examination as in your mother. To confirm that a polyp is benign, a biopsy (removal) is necessary with a small instrument. The base of the polyp may be scraped to make sure all of the polyp is removed. The biopsy can usually be done in the clinic. Removal of the womb is usually not necessary.
Please see Cervical Polyp for further details.

Chickenpox is a highly infectious disease that usually causes an itchy red rash with blisters. It is one of the most common childhood diseases and can affect pregnant mother. The vaccine contains a weakened form of the chickenpox (varicella-zoster) virus and works by causing the body to produce antibodies (resistance) to protect against the disease.
The vaccine is administered by injecting the vaccine under the skin of the upper arm or thigh. Adults are generally given two doses, one to two months apart. The vaccine can have side effects; however, these are usually not serious.
Please see web page on Chicken Vaccination for further details.

Chlamydia is one of the common sexually transmitted disease in Singapore. The infection is easily spread because it often causes no symptoms and may be unknowingly passed to sexual partners.
Please see web page on Chlamydia for details.

Chlamydia is passed from one person to another through sexual activity such as:   

vaginal or anal sex with an infected person

  

oral sex

  

sharing sex toys

It can also be passed from a mother to her baby at birth. Chlamydia cannot be transmitted by kissing, hugging, sharing towels, cups, plates or from toilet seats.
Generally, doctor uses a swab to take secretion from the infected area, such as the neck of the womb (cervix), urinary passage (urethra), penis, anus, or throat. The test is to look for the bacterium Chlamydia trachomatis. It may be possible to use a urine sample, but a new, very sensitive molecular technology has to be used for this purpose. Cervical smear test does not detect chlamydia infection.
To avoid Chlamydia infection, the surest way is to maintain a monogamous relationship with a partner who has not been infected. Condom (Male or Female) does not completely stop the transmission.

CVS is an invasive diagnostic test to detect genetic abnormalities of the baby. It is done at about 9-11 weeks of pregnancy using a sharp instrument to obtain a small piece of placental tissues through the birth canal. The tissue is then cultured to provide analysis of the chromosomes. The advantage is that the test is done at an earlier period of pregnancy, so that the mother can know the results earlier. However, the risk of miscarriage is higher than that of amniocentesis and placental cells may have different chromosomes from those of the developing baby.
Click here for more information.

Please see our page on Abnormal Pap Smear and Colposcopy for answer.

Condom can only reduce the risk of HIV transmission, but cannot eliminate that risk. An authorative study in the US released in July 2001 showed that correct and consistent use of condoms was only 85% effective in preventing the transmission of HIV. This means that there is a failure rate of 15% for transmitting HIV. Click here for more details on condom.

To understand how oral contraceptive pill works, one has to understand how pregnancy comes about. Normally a woman becomes pregnant when an egg released from the ovary (ovulation) is fertilized by a man's sperm during sexual intercourse. The fertilized egg then moves along the fallopian tube and attaches to the woman's womb (implantation), where it receives nourishment and develops into a baby. Hormones in the woman's body control the release of the egg from the ovary and prepare the womb to accept the fertilized egg.
The pill contains a small amount of artificial hormones. Some of these hormones prevent pregnancy by stopping the ovary from releasing the egg while others work by making the lining of the womb too thick or too thin to accept the fertilized egg. There are side effects associated with oral pills. Majority are minor. However, there may be rare serious side effects including disorders of the liver and gallbladder, stroke, blood clots, high blood pressure or heart disease and breast cancer. The pill can be taken safely by most women, but is not recommended for women who are over the age of 35 and smoke. For a more complete answer, please see Contraceptive Pills.

The advantages of storing the baby's cord blood are as follows

• It might save the baby's or another family member's life at some point in the future.
• There is only one chance to bank the baby's cord blood at birth.
• The cord blood collection process is simple, painless, and harmless to the baby and mother.
• People who need bone marrow transplants may have problem finding a match. By banking the baby's stem cells, the odds of having a proper match for the baby or another family member improve.
• Future medical advances might allow stem cells to treat even more diseases and be used in more transplant cases than current medical practices.

Please see Cord Blood Stem Cells for further details.

Food cravings are strong urges to eat certain foods that you may not have previously desired. They typically differ from pregnancy to pregnancy and may change from day to day. Sometimes, pregnancy can change food preferences permanently.

Majority of women have at least one food craving (usually rich in calories) during pregnancy. No cause has been scientifically established. It is not due to hormonal changes which may affect taste and smell. It is also not due to nutritional deficiency although pica which is a craving for bizarre substances such as dirt has been linked to deficiency in iron intake.

As long as your sweet cravings do not interfere with normal diet, you can still provide the baby with the necessary nutrients. However, giving in too much to your desire for high calorie foods may translate into too much weight gain. This may increase the risk of diabetes and raised blood pressure during pregnancy.

To handle sweet cravings you may like to try the following:

To prevent hemorrhoids from getting worse the following measures would help:

• Eat a healthy balanced diet that includes protein, fruit and vegetables. Eating lots of fruits and vegetables will leave very little room for anything sweet in your stomach.
• Focus on lower calorie foods such as low fat milk, cheese, low calorie biscuits, sorbet and sherbet. Substitute healthy alternatives such as low fat yogurt instead of ice cream, or plain water instead of soft drinks.
• Do not skip breakfast. This could only cause your cravings to increase throughout the day. Eating frequent and small meals may avoid a reduction in blood sugar that could trigger food cravings.
• Distraction: Occupy yourself with regular physical activity, running an errand, calling a friend or reading.
• Get emotional support from your spouse. The physical and hormonal changes during pregnancy can put a lot of emotional strain on you. Your cravings may be related to emotional stress.
• Think small. If you cannot resist eating something sweet, take small portions each time.
• Subscribe to magazine that provides healthy recipes and ideas for tasty, low calorie desserts. You should not have unnecessary anxiety as cravings may lessen in the last trimester.

Emergency contraception means pregnancy is prevented by temporarily blocking ovulation, by stopping fertilization, or preventing a fertilized egg from becoming implanted in the uterus. It is used in unprotected sex.
Emergency contraception is usually done in two ways: taking contraceptive pills or inserting a copper-releasing intrauterine device (IUCD).

1. Emergency Contraceptive Pills are most commonly used and are taken in two doses. The first dose is taken within 72 hours of unprotected intercourse, and the second dose 12 hours later. The most common side effects associated with emergency contraception include nausea, abdominal pain, fatigue, headache and menstrual irregularity. However, it is about 70% effective when taken within 72 hours of unprotected sex.
2. An IUD is inserted to prevent pregnancy up to five days after unprotected intercourse.

Emergency contraception should not be used by women who are already pregnant because it is ineffective in aborting established pregnancies and does not prevent sexually transmitted diseases.

Like male condom, female condom is one of the barrier methods of contraception. It is a lubricated polyurethane (a thin, soft, odorless, plastic) tube; about 6.5 inches long and has a flexible ring at each end of the sheath. The inner ring at the closed end is used to insert the condom and to hold it in place inside the vagina.
Before sexual activity begins, the woman inserts the condom into her vagina so that the closed end of the tube covers the cervix, and the other end slightly covers the labia (lips on the outside of the vagina). The condom loosely lines the vagina and is not tight or constricting. Please see Female Condom for more details.

An IUCD, or intrauterine contraceptive device or IUD, is a small, plastic, flexible, T-shaped device that is placed into the uterus (womb) and prevents pregnancy. It has to be inserted by trained doctor.
There are basically two types of IUCD. One type of IUCD contains copper, which is slowly released into the uterine cavity. Another type releases the hormone progesterone, which causes the cervical mucus to become thicker so the sperm cannot reach the egg.
Please see IUCD for further details.

A. Cervical incompetence is a medical condition where there is structural weakness in the neck of the womb (cervix). It is usually the result of prior injury such as abortion or from an inherited condition. The physical weakness in the cervix makes it susceptible to ¡®giving way¡¯ as the baby becomes larger and heavier.

Typically, the cervix opens up silently with minimal womb contractions in the second trimester of pregnancy. This is followed by a sudden gush of amniotic fluid when membranes rupture. The baby is delivered prematurely following a short labor.

Accurate diagnosis is usually difficult because there are no well-defined criteria. In most cases, the condition is diagnosed in retrospect, after one or more miscarriages in the second trimester.

Recently, using ultrasound technology, objective evaluation of the cervix during pregnancy becomes possible. Cervical incompetence is now more readily detected by continuous monitoring in women with a history of second-trimester miscarriage.

Once incompetence is diagnosed, this may be treated through a surgical procedure called cerclage where a purse string suture is placed around or through the cervix to keep it tightly closed.This is usually performed after the twelfth week of pregnancy after ultrasound evaluation has demonstrated the presence of a live baby with no apparent abnormalities. Cerclage can also be done for twin pregnancy. Risks of the operation are usually minimal and include:

• Premature contractions of the womb leading to miscarriage
Membranes of the water bag may be punctured accidentally and the baby delivered prematurely
• nfection of cervix causing miscarriage
• Tearing of cervix if labor happens before the stitch is removed
• Scarring of the cervix causing difficulty for it to open up during labor
• Risks associated with general anesthesia include vomiting and nausea

Patients should be monitored carefully after operation. She may remain on bed rest for a few days so as to remove any pressure on the cervix and increase the chance of retaining the pregnancy. Sexual intercourse, heavy exertion and prolonged standing should be avoided at least for a week.