Vaccinations & Screenings during Pregnancy in Singapore
What vaccinations can I take during pregnancy?
Most women tolerate vaccinations well. Some side effects may include: mild fever, pain/ swelling/ redness at injection site, muscle aches, fatigue, nausea, headaches. Rarely, it may cause allergic reactions. There is a very small chance of an immediate severe allergic reaction called anaphylaxis, an extremely rare event that can cause life-threatening breathing difficulties which although serious, is treatable.
The following vaccinations are safe and encouraged to take during pregnancy:
Pertussis (Whooping Cough) Vaccination Flu (Influenza) Vaccination
Whooping cough is a highly infectious disease that can cause serious complications such as breathing difficulties and death in young babies. Babies less than 3 months old are most vulnerable to severe whooping cough.
The National Immunisation Programme in Singapore vaccinates children against Pertussis only at 3 months of age; hence vaccinating yourself while pregnant allows you to make antibodies against Pertussis, transfer them through the placenta, and protect the baby for the first 3 months of life.
The Boostrix vaccine protects against Diphtheria, Tetanus and Pertussis (there is no single Pertussis vaccine available) and is safe during pregnancy. You may take the Boostrix vaccine between 16 to 32 weeks of pregnancy. Do get vaccinated in each pregnancy even if you have received it before. The vaccine contains neomycin and polymyxin (antibiotics) – please inform your doctor if you are allergic to these.
Pregnant women who catch the flu have a higher risk of serious complications and hospitalisation from the flu virus compared to the general population. Babies born to mothers who had flu are four times more likely to be born prematurely and/or have a low birth weight.
You may take the Influenza vaccine at any time of your pregnancy. This is safe for both you and the baby, and can be taken at the same time as the Boostrix vaccine. Vaccinating yourself while pregnant allows you to make antibodies against influenza, transfer them through the placenta, and protect the baby for the first few months of life. Do get vaccinated in each pregnancy even if you have received it before.
The vaccine contains small amounts of egg proteins and should be avoided only in those with severe egg allergies. It may also contain tiny traces of antibiotics such as neomycin, polymyxin, gentamicin or kanamycin – please inform your doctor if you are allergic to these.
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Down Syndrome Screening in Singapore
| SCREENING TESTS FOR DOWN SYNDROME | First Trimester Screen/ Combined test/ OSCAR | Non-invasive prenatal test (NIPT) |
| When to do? | 11 to 13 week 6 days | From 10 weeks onwards |
| What does it consist of? | 1.Age 2.Ultrasound scan (measure nuchal translucency) 3.Blood test [for 2 pregnancy-specific substances in maternal blood (PAPP-A and HCG)] | 1.Ultrasound scan (measure nuchal translucency) 2.Blood test [for placenta DNA (cffDNA) circulating in maternal blood) |
| What is the detection rate? | 90% | 99% |
| Other than the common trisomies, what else can the test detect? | Nil | (Optional at no extra cost) Fetal gender Additional things e.g. sex chromosome aneuploidies, deletion syndromes etc with lower sensitivity |
| What is the risk to my baby? | None | None |
| How long does it take for my results to come back? | 7 working days | 14 working days |
| What are the possible results? | Low risk* Intermediate risk High risk | Low risk* High risk No result (insufficient cffDNA) |
| What if my results come back intermediate/high risk? | Intermediate risk: option of NIPT or diagnostic invasive test (CVS/amniocentesis) High risk: require diagnostic invasive test | Require diagnostic invasive test (CVS/amniocentesis) as this is a screening test |
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Gestational Diabetes Mellitus in Singapore
What is gestational diabetes (GDM)?
Gestational Diabetes means having high blood sugar levels in pregnancy, usually during the second half. GDM can increase the risk of your baby developing problems, such as macrosomia ()big baby), polyhydramnios (excessive liquor), or low blood sugar after delivery (neonatal hypoglycaemia). The chances of having these problems can be reduced by controlling your blood sugar (glucose) levels. You will need to be closely monitored during pregnancy and labour.
What are the warning signs of gestational diabetes?
The symptoms of gestational diabetes tend to overlap with symptoms of pregnancy. They include:
- Extreme fatigue and lethargy
- Constant urge to urinate
- Dry mouth and constant thirst
- Extreme nausea after eating
- Strong cravings for sweets
- Blurred vision
- Tingling in hands or feet
Is gestational diabetes caused by diet?
There is no surefire way to prevent gestational diabetes, and there is no specific food that causes this condition. However, diet and exercise [link to diet & exercise page] play a huge role in managing gestational diabetes and controlling your blood sugar levels.
In general, do:
- eat a high protein, low carb diet e.g. fish, chicken and egg whites
- If eating carbs, eat small portions of low-glycemic index (GI) ones e.g. whole-wheat pasta, brown rice, granary bread, all-bran cereals, pulses, beans, lentils, muesli and plain porridge – these release sugar slowly.
- eat at least 5 portions of fruit and vegetables a day – avoid very sweet fruits like mango, chikoo, grapes, banana and durians.
- avoid sugary foods and drinks – swap cakes/biscuits for healthier alternatives e.g. fruit, vegetables like – cucumber and celery with a yoghurt dip, 10-12 pieces of nuts, seeds. Fruit juices and smoothies should be avoided as they are high in sugar.
Do mothers with gestational diabetes deliver early?
Depending on the control of GDM, some women may need earlier delivery. This may mean inducing your labour after discussion with your doctor. When you go to the hospital to give birth, remember to take your blood sugar test kit and your medications. During labour and delivery, your blood sugar will be monitored and kept under control (this may mean an insulin drip).
If your blood sugar levels are normal and there are no problems with the pregnancy, you may wait for natural labour to occur. If you have not delivered by 40 weeks, an induction of labour or caesarean section may be offered.
What does gestational diabetes do to the baby?
It is important to hold and feed your baby as soon as possible after birth (within 30 minutes) and then at frequent intervals (every 2-3 hours) until your baby’s blood sugar levels are stable. Your baby’s blood sugar level will be tested starting after birth. If it’s low, your baby may need temporary feeding through a tube or a drip. If your baby is unwell or needs closer monitoring, he/she may need to stay in a neonatal special care unit.
You will need a blood test to check for resolution of GDM 6 weeks after giving birth. This is because a small proportion of women with GDM continue to have raised blood sugar after delivery. If the result is normal, do have an annual test for diabetes as you are at 50% risk of developing Type 2 diabetes with your history of GDM.