At The Choolani Clinic, we keep abreast of all the latest developments in Obstetric care, bringing you the best advancements and the highest standards of care.

Our high risk pregnancy care and management is recognized by our patients to be exceptional. We regularly look after pregnant patients with Pre-Eclampsia,Diabetes in Pregnancy, Bleeding in Early Pregnancy, Recurrent Miscarriages, Ectopic pregnancy, Bleeding in Late Pregnancy, Placenta Praevia, Placental Abruption, Asthma, Liver conditions, Blood disorders, Cancer in pregnancy, and more 

Pre-Eclampsia
Pre-eclampsia is a condition where the mother’s blood pressure is elevated and she is releasing protein in her urine. The outcome of the pregnancy would depend on the severity of the pre-eclampsia. In this condition, both the mother and the fetus are at risk of a poor pregnancy outcome. 

Several conditions such as a previous, or family history of pre-eclampsia, diabetes or kidney disease predisposes some mothers to having pre-eclampsia in this pregnancy. Pregnant women over the age of 35 are also at higher risk.


Diabetes in Pregnancy
A woman could suffer from diabetes during pregnancy if she was already diabetic before pregnancy, or if she develops it during pregnancy. This type of diabetes is known as Gestational Diabetes Mellitus.

The risk factors for diabetes in pregnancy include a family history of diabetes, older mom, being overweight, carrying a big baby or a baby with a birth conditions. A glucose screening test performed between the 24th and 28th weeks of pregnancy can help diagnose gestational diabetes. 

The Choolani Clinic specializes in the management of such pregnancies with regular blood glucose monitoring, and insulin injections to keep blood glucose levels normal.


Bleeding in Early Pregnancy
During the early stages of pregnancy, bleeding can occur during implantation, when the fertilized egg attaches itself to the wall of the uterus. Light bleeding or spotting sometimes accompanies implantation, but no matter how light the bleeding it is important to let your doctor know. Some common problems associated with bleeding in early pregnancy include miscarriage and ectopic pregnancy.


Miscarriages
A small group of women (5%) will experience two or more miscarriages. Miscarriages are usually signalled by bleeding in early pregnancy, accompanied by abdominal cramps and backache. 

The miscarriage can take many forms for instance, the fetus may not develop at all (blighted ovum), the heartbeat does not appear (missed), the miscarriage in imminent (inevitable), has occurred partially (incomplete) or is complete.

 At The Choolani Clinic, we have developed a specialized methodology for investigating and managing couples with recurrent pregnancy losses. Our care and management plan is highly effective with many couples fulfilling their desire to grow and complete their families. Our methodology has been adopted by many clinics in Singapore and the region.


Ectopic pregnancy
An ectopic pregnancy is a pregnancy that occurs outside the uterus – usually within the fallopian tube, but occasionally in the cervix, ovary or even within the greater abdominal cavity. In almost all cases, the baby does not survive, but the occurrence of an ectopic pregnancy poses a significant risk to the mother. If it ruptures, it can lead to significant bleeding within the mother’s abdomen.

Usually, the mother would experience some bleeding in early pregnancy associated with abdominal pain. The diagnosis of this condition requires detailed examinations, blood tests, and ultrasound. 

Laparoscopy may also be required to make the diagnosis. The usual treatment for this condition is surgery, which may be done via a laparoscope (key hole surgery) or by the open method, depending on the severity of the condition suspected. In very special cases, the condition can be managed using specialised medications.


Bleeding in Late Pregnancy
Bleeding late in pregnancy can be a sign of normal labour. There are also many abnormal causes of bleeding in later pregnancy. About half of these are accounted for by placental causes such as placenta praevia or placental abruption. Other causes can include lesions of the cervix not previously recognized, preterm labour and even bleeding for no obvious cause. Whatever the cause, bleeding in later pregnancy is not normal, and should be investigated by your obstetrician.


Placenta Praevia
Placenta praevia is a pregnancy complication that can cause abnormal bleeding before or during delivery. Early in pregnancy, the placenta may implant in the lower part of the uterus. As the uterus grows, the placenta usually moves up and away from the cervix. If the placenta continues to stay low and if it blocks the cervix, it may be associated with bleeding later in pregnancy. Often this bleeding occurs suddenly, and not associated with any pain.

Placenta praevia may reveal itself when a mother experiences painless vaginal bleeding in the second half of the pregnancy, but an ultrasound examination will reveal placenta praevia even before the very first bleed. Often patients with placenta praevia experience repeated episodes of bleeding.


Placental Abruption
Placental abruption is a pregnancy complication that can cause abnormal bleeding before or during delivery. Unlike placenta praevia, the placenta is located at the normal position, usually at the fundus (top) of the uterus.

Ultrasound might reveal a clot behind the uterus, but often the diagnosis is made based upon clinical findings. Abruptions tend to occur without warning, and can have serious consequences for the mother and the baby. If the abruption is severe, the delivery may need to be expedited.