Antenatal Care

Antenatal care is your healthcare roadmap during pregnancy, meant to protect you and your baby. But when should you start, and what should you expect?

Find out more about the essentials of antenatal care in Singapore, such as the key stages and interventions that contribute to a safe, healthy pregnancy and delivery.

The importance of antenatal care

Monitoring maternal health

Antenatal care services involve regular check-ups with healthcare providers to monitor your health throughout pregnancy. Early detection and management of any maternal health issues can help prevent complications during pregnancy and childbirth.

Fetal monitoring

Antenatal care services include various tests and screenings to monitor the health and development of your unborn baby. It allows for the detection of abnormalities so they can be immediately addressed.

Prevention and management of complications

Antenatal care involves identifying and addressing risk factors and potential complications that may arise during your pregnancy. Through regular monitoring and proactive management, healthcare providers can lower the risk of preterm birth, low birth weight, congenital disabilities, and other adverse outcomes.

When should I start prenatal check-ups?

Ideally, the first prenatal check-up should be scheduled before the tenth week of pregnancy.

The first visit confirms pregnancy and reviews your general health and medical history. After that, check-ups will be scheduled once a month until your 28th week, once every two weeks from the 28th to the 36th week, and once a week from the 36th to the 40th week of pregnancy.

For high-risk pregnancies, such as those with multiple fetuses or pre-existing conditions like lupus, more frequent prenatal check-ups may be necessary.

Antenatal care services checklist

Ultrasound scan

  • Typically performed around 6-8 weeks of pregnancy
  • Confirms the pregnancy and establishes the gestational age
  • Checks for the number of embryos verifies the location of the pregnancy (intrauterine or ectopic)
  • Assesses the fetal heartbeat

Nuchal Translucency (NT) scan

  • Performed between 11-13 weeks of pregnancy
  • Measures the thickness of the fluid at the back of the baby's neck.
  • Increased NT measurement may indicate a higher risk of chromosomal abnormalities, such as Down syndrome.

First-trimester blood tests

  • Combined First Trimester Screening (FTS) assesses the fetal nuchal translucency and nasal bone via ultrasound scan and combines the information with certain hormones in the mother's blood to screen for chromosomal abnormalities.
  • Non-invasive prenatal testing (NIPT) assesses the cell-free fetal DNA that is in the mother’s blood and can detect up to 99% of all pregnancies with Trisomy 21. It can also screen for other chromosome abnormalities such as Edward’s syndrome, Patau’s syndrome. Turner’s syndrome, DiGeorge syndrome and triploidy.

Anomaly scan (Mid-Pregnancy Ultrasound)

  • Performed between 18-22 weeks of pregnancy
  • Checks for structural abnormalities in the baby's organs, such as the brain, heart, spine, kidneys, and limbs.
  • Evaluates the placenta, umbilical cord, and amniotic fluid volume.

Group B Streptococcus (GBS) Screening

  • Performed between 35-37 weeks of pregnancy
  • A swab of the vagina and rectum is taken to screen for Group B Streptococcus bacteria. GBS can be passed to the baby during childbirth and may cause serious infections, so antibiotic prophylaxis is recommended for carriers during labour.

Fetal movement counting

  • It starts around 28 weeks of pregnancy
  • A decrease in fetal movements may indicate fetal distress and should be promptly reported to healthcare providers.

Biophysical Profile (BPP)

  • May be performed if there are concerns about fetal well-being
  • This test combines fetal heart rate monitoring (non-stress test) with ultrasound assessment of fetal breathing, body movements, muscle tone, and amniotic fluid volume to evaluate fetal health and development.

Glucose challenge test (GCT)

  • Done around 24-28 weeks of pregnancy
  • Further testing with a glucose tolerance test (GTT) may be recommended if the initial screening is abnormal.

Antenatal Screening Tests & Procedures

There are a variety of antenatal diagnostic tests you can do to ensure the health of your baby. Dr TC Chang is the Head of Maternal Fetal Medicine at the Fetal Assessment Unit, Thomson Medical Centre, Singapore, and performs the following invasive procedures in the Fetal Assessment Unit.

Amniocentesis is a prenatal diagnostic procedure that involves the extraction of a small amount of amniotic fluid from the amniotic sac surrounding the fetus. This procedure is usually performed between the 15th and 20th weeks of pregnancy.

Under ultrasound guidance, a thin needle is inserted through the abdominal wall into the amniotic sac. A small amount of amniotic fluid, which contains fetal cells, is then withdrawn for analysis.

Amniocentesis is primarily used to detect chromosomal abnormalities such as Down syndrome (trisomy 21), neural tube defects, and genetic disorders. It can also determine the sex of the fetus and assess lung maturity in certain cases.

Chorionic villus sampling, often abbreviated as CVS, is another prenatal diagnostic test used to examine fetal chromosomes. Unlike amniocentesis, CVS can be performed earlier in pregnancy, typically between the 10th and 13th weeks.

During CVS, a small sample of tissue (chorionic villi) is taken from the placenta, which contains genetic material from the developing fetus. This sample can be obtained through the cervix (transcervical CVS) or the abdomen (transabdominal CVS), guided by ultrasound imaging.

CVS is primarily used to diagnose chromosomal abnormalities, such as Down syndrome, as well as certain genetic disorders. Because it can be performed earlier than amniocentesis, CVS provides results sooner, allowing for earlier decision-making regarding the pregnancy.

Percutaneous umbilical blood sampling, or PUBS, is a diagnostic procedure used to directly sample fetal blood from the umbilical cord. This procedure is typically performed later in pregnancy, usually after 18 weeks gestation.

Under ultrasound guidance, a needle is inserted through the mother’s abdominal wall and into the umbilical cord to obtain a small sample of fetal blood. This blood sample can then be analyzed for various genetic conditions and fetal abnormalities.

PUBS is used to diagnose certain blood disorders, infections, and genetic conditions that cannot be detected through other prenatal tests. It provides a direct assessment of the fetal blood, allowing for more accurate diagnosis and potential treatment options.

Trimester Performed
Sample Obtained
Amniotic Fluid
Chrosomal abnormalities, genetic conditionsChrosomal abnormalities, genetic conditions
Miscarriage, infection
Chorionic Villus Sampling (CVS)
Chorionic villi
Chrosomal abnormalities, some genetic conditions
Miscarriage, limb defects
Percutaneous Umbilical Blood Sampling (PUBS)
Second or Third
Fetal Blood
Chrosomal abnormalities, genetic conditions, blood disorders, infections, metabolic conditions
Miscarriage, infection, bleeding

Antenatal care for high-risk pregnancy

Antenatal care is essential for high-risk pregnancies as it enables healthcare providers to closely monitor and manage potential complications such as pre-eclampsia, gestational diabetes, and fetal growth restriction.

Antenatal care also emphasizes preventive measures to reduce the risk of complications, such as lifestyle counselling and early screening for genetic disorders, and helps in preparing a tailored birth plan for safe delivery, including discussions about timing, mode of delivery, and neonatal care if needed.

Here are some indications of a high-risk pregnancy:


Early and regular prenatal care

High-risk pregnancies usually require earlier and more frequent prenatal check-ups so doctors can closely monitor the mother and baby’s health and detect any potential issues early.


Comprehensive health assessment

Your current health status and medical history, including any pre-existing conditions, previous pregnancies, and family medical history, will be thoroughly reviewed.


Specialised testing

High-risk pregnancies may require additional tests and screenings to assess fetal development and monitor for complications.


Management of pre-existing conditions

Pre-existing conditions such as diabetes, hypertension, or autoimmune disorders require specialised care to manage these conditions during pregnancy. Your doctor may call for medication adjustments, dietary changes, and close monitoring of symptoms during prenatal care.


Lifestyle counselling

High-risk pregnancies often necessitate lifestyle modifications such as dietary advice and recommendations for exercise to reduce the risk of complications.


Consultation with specialists

You may need consultations with various specialists, such as maternal-fetal medicine specialists, endocrinologists, cardiologists, or genetic counsellors to manage your risks.


Anticipatory guidance and education

Healthcare staff provide information on potential complications, warning signs to watch for, and instructions on when to seek medical assistance.


Emotional support

Healthcare providers offer emotional support and counselling to help manage anxiety and concerns throughout the pregnancy.

Antenatal care services in Singapore

Pregnancy can evoke joy and excitement but sometimes also coincides with uncertainty. At our clinic headed by Dr TC Chang, we understand the emotional rollercoaster that expectant mothers experience, and we strive to provide compassionate and supportive care to address your needs throughout pregnancy.

We provide antenatal care services in Singapore that prioritise both mother and baby’s health, well-being, and safety. We aim to empower expectant mothers to embrace pregnancy with confidence and peace of mind.

Frequently Asked Questions

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