Everyone needs a detailed scan because everyone has a 3-5% chance of baby with abnormality.

• There are many advantages to diagnose problems before birth.
• Some conditions are life threatening even before birth and best treated before birth.
• Some other conditions affect baby’s breathing and heart beat and if not discovered can be lethal at birth.
• Some conditions require that baby be born in specialized centres.
• Some conditions require surgery soon after birth or it will only be discovered after baby gets very sick.
• And some other conditions require long term monitoring, again babies becoming very sick before they are discovered.

In summary, it is a very good decision to have a detailed scan and plan for things should there be a problem.

• This is not true. 70% of total anomalies are structural anomalies.
• This is constant across age groups. Older women need the 1st trimester Genetic Scan more than younger moms.
• The risk for genetic conditions like Down Syndrome genetic increases with age.

• Down syndrome can affect babies of moms in all age groups.
• It occurs less frequently in the younger and more frequently in the older ages.
• A 25 year old mom has a 1:1500 chance, A 30 year old mom has a 1:480 chance and a 35 year old mom has a 1:270 chance of having a baby with Down Syndrome.
• All moms should have a Down Syndrome discussion and screening options early in pregnancy.

This really depends on your budget. 

• RM 250: Ultrasound alone at Aseana can immediately give a risk estimate with a 90% detection rate missing only 10%. This is the 1st trimester genetic scan done between 11 and 14 weeks of pregnancy.
• RM 550: Combined ultrasound and blood, the FTS, has a detection up to 95%. (Week 11 to 14)
• To change RM 1800: direct DNA detection tests (NICC / NIPT) has a detection of 99.9% (Week 10 onwards) (depending choice of lab)
• Everyone should have the ultrasound risk calculation as the basis because it also gives other information such as if the baby has major anomalies seen early in pregnancy and if the pregnancy is going to be a high risk one. You can then opt for more sensitive tests for Down Syndrome prediction.
• All tests are not perfect and have their limitations.

• This is one of the tests for Down Syndrome.
• It only requires a sample of mom’s blood.
• Fetal DNA circulates in mom’s blood.
• The DNA fragments actually originate from the placenta that has similar genetic make-up with baby’s.
• The test is very accurate as it directly analyses DNA.
• It detects 99.9% of Down Syndrome cases making it the most sensitive test available.
• As with other tests it can also be falsely showing high risk (falsely positive) and falsely negative, missing the condition being tested for.
• This is rare, about 1 in 10,000.
• This test can be done from the 9th or 10th week of pregnancy, depending on the labs.
• It does not give any other information regarding the baby or the pregnancy.

Yes, you do. The NIPT tests screen for specific conditions detailed on the test results. The conditions tested with NIPT are the most common ones. There are many more genetic conditions possible. The 1st Trimester Scan allows us to predict if the baby has a higher chance of having ANY genetic condition, so it is more general. Furthermore, it gives additional information:

• It also allows for the detection some major structural anomalies visible earlier on in the 1st trimester.
• The 1st trimester scan is also used to predict if the pregnancy is going to be a high risk one – Risk Assessment test (link)

• A test that returns as High Risk has not confirmed the condition.
• Of all HIGH RISK tests done only 40-50% will actually be positive confirming Down Syndrome.
• The rest of the ‘HIGH RISK’ cases are falsely positives.
• This is why it is important to confirm with CVS or amniocentesis after a High Risk test.

Yes, you do. The 1st trimester scan does detect some structural problems seen early but it is mainly to assess the potential for genetic conditions.

• The second trimester detailed structural scan is able to detect up to 80% of major anomalies.
• Combined with a normal 1st Trimester genetic scan, baby can be 90% clear off major problems now.

The short answer is no.

• Some malformations are too subtle for ultrasound to pick up.
• Others only show at later stages in pregnancy (picked up at the 30-week scan).
• The structural detailed scan can detect up to 80% of anomalies as single point analysis.

No.

• Ultrasound detects structural problems and indirectly, genetic problems too.
• Autism is a functional anomaly.
• It is multifactorial.
• There is a list of autism spectrum conditions with genetic basis.
• These can be diagnosed early with genetic tests after amniotic fluid or placental biopsy with amniocentesis or chorionic villous sampling.

• The 1st detailed scan is a screening scan.
• It is designed to cover the whole baby at an early stage.
• When a problem is detected, a focused detailed scan will be advised at a later date to allow for even more analysis after the baby has grown a little bigger.
• This will add to the details of the diagnosis and help prepare for the baby’s care after birth better.

Yes, it is.

• Ultrasound has been used on pregnancies since the 1970’s.
• There are no reports on anomalies caused by ultrasound up until today provided their proper use in trained hands.

These are all social scans.

• The 3D function is simply to show the baby in a more recognizable form.
• 4D is simply live 3D.
• The other Ds have no real definitions nor value apart from social scans.

• Some specialties are dedicated to this.
• They are called Fetal Medicine Consultants.
• Some general OBGYN have special interest in this and offer the scans.
• Some general practitioners employ sonographers and offer detailed scans in their practice.

Detailed scans are best done in a setting where there are Fetal Med specialists in supervisory roles to ensure scans are ALWAYS performed to set standards and to offer expert consults if there are problems encountered in the baby.

If a dedicated service like Aseana Pregnancy Scans is not available near you, any service looking into the baby in a detailed way is better than nothing.

Not necessarily.

• But the baby has a higher chance of having a similar problem.
• If either parent has a hole in the heart, for example, the baby has a 4% chance of it too.
• Some conditions like short arms and legs may carry a 50% transmission risk to the baby.

There is a misconception that pregnancy requires a list of supplements. This is NOT true. Here is the dropdown of supplements and pregnancy.

1. Folic acid started before pregnancy up until end of the 1st trimester will help reduce risk of a certain anomaly of brain and spine called neural tube defect.
2. In early pregnancy, there is growing evidence that fish oils consumed in early pregnancy helps with early fetal growth. This is only true in populations that do not consume fish rich in oils.
3. Calcium started at 20 weeks will reduce the chance of you developing hypertension syndromes in pregnancy. It also helps with moms and baby’s bone formation. This should be stopped only 3 months after stopping breastfeeding.
4. Vit D supplementation in populations that tend to wear all-covering clothes that significantly reduces sun exposure will help with bone formation in both mom and baby.
5. Thereafter the 6 or 7th month iron supplementation can be started IF your diet is deficient of this.

Any other supplementation not mentioned here is of no added benefit to taking your normal balanced pregnancy diet.