In Malaysia, there are two parallel healthcare systems: Private and public. Both are of high standards and your choice may depend on your financial capability or access to either of the care based on your individual considerations.
If there are any problems, you should see an obstetrician. If there are any medical complications or problems with your baby, you will then need to see a maternal fetal medicine specialist. This subspecialist manages mother and baby complications during gestation to ensure a safe pregnancy and the best outcomes for both.
The usual schedule for clinic visits are usually four weekly until 28 weeks of pregnancy – then fortnightly until 36 weeks of pregnancy and weekly until delivery. However, if there is a need, for whatever reason, these appointments could be changed to suit your needs.
However, for some people, the red blood cell count does not increase proportionately and may cause anaemia, which needs to be treated.
As the rate of diabetes is very high in Malaysia, this test is now routinely done to exclude those who have diabetes complicating their pregnancy and those that develop gestational diabetes during their pregnancy.
Screening
The first scan that needs to be done is during the initial stage of your pregnancy. Here is where the location of the pregnancy inside the uterus, date of pregnancy and the number of foetuses will be determined. If there are more than a single fetus, there will be a need to determine the type of multiple pregnancy. The earlier the scan is done, the more accurate these findings will be. The baby’s heartbeat will also be checked to determine if it is alive and well.
The next one usually takes place between 18 to 22 weeks. Ideally, this should be done by a maternal fetal medicine specialist. During this time, the structure of the baby is scanned to ensure the baby has no physical abnormalities.
The growth of the baby is also assessed to ensure it is growing on the correct graph. If it is not, you need to be referred to a maternal fetal medicine specialist.
If you have the opportunity and funds, you can have an ultrasound examination during every visit to ensure your baby is growing in the normal graph and is well. This will give you reassurance that everything is normal.
This article is contributed by consultant obstetrician & gynaecologist, maternal fetal medicine Datuk Dr H. Krishna Kumar.
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