Tony Tan Women and Fetal Clinic

21/04/2026

Avoiding drinking alcohol while pregnant protects your health and your baby’s. Consuming alcohol during pregnancy can interfere with fetal development, causing birth defects and lifelong problems for your child.

If you’re struggling to stop drinking while pregnant, you’re not alone. Your ob-gyn can offer support and direct you to resources that can help. Counseling and treatment are available if you’re having a hard time quitting drinking on your own.

Visit our FAQ page for more information and resources on avoiding substance use during pregnancy: https://bit.ly/42ksnhT

21/04/2026

Hormone replacement therapy started within 10 years of the last menstrual period reduces all-cause mortality (meaning less likely to die prematurely) and osteoporosis.

https://www.facebook.com/share/1Ak4k4oamY/?mibextid=wwXIfr

Major Update in Women’s Health: The FDA has officially removed "black box" warnings from six menopausal hormone therapies.

A comprehensive review of the latest evidence shows that for women starting therapy within 10 years of menopause onset (especially before age 60), there is a significant reduction in fractures and all-cause mortality. This change ensures that both women and healthcare professionals can make decisions based on the most current safety and benefit data.

Stay informed with the latest evidence-based management protocols on BMJ Best Practice: https://bestpractice.bmj.com/topics/en-us/194

18/04/2026

Attending a Fetal Therapy Workshop at KK hospital.

With Prof Greg Ryan from Toronto and Prof Liona P**n from Hong Kong. Practicing on a model to do laser for twin-twin transfusion syndrome in anterior placentas.

Also practiced on models for fetal in utero transfusion for fetal anaemia, fetal shunt insertions for fetal pleural effusion, radiofrequency ablation for acardiac twins and ultrasound guided cord occlusion with bipolar diathermy for monochorionic twins.

17/04/2026

Met an old friend, Dr Angelita Teotico, a Maternal Fetal Medicine Specialist from Manila at a meeting in KK hospital.

Gave a talk on “Cervical Length Screening” to encourage all to offer universal transvaginal ultrasound scan for cervical length at 20 weeks. This is because there are interventions like vaginal progesterone and cervical cerclage to reduce the risk of spontaneous preterm labour, and also allows screening for vasa praevia and allows more accurate diagnosis of placenta praevia.

30/03/2026

Spoke on 2 topics before the Obstetrical and Gynaecological Society of Singapore Annual General Meeting:

1. The use of continuous glucose monitor (CGM) in obstetric practice - can use in gestational diabetes mellitus to reduce rates of large for gestational age fetus whilst being careful to avoid overzealous control which may result in small for gestational age fetus. Best to combine the use of CGM with close ultrasound surveillance of the fetal growth for optimal control and growth. Need to set appropriate glucose targets that are individualized.

2. Real World Evidence of maternal RSV vaccination - effective in reducing risk of severe RSV infection to the infant < 3-6 months without any increase in risk of preterm birth.

27/03/2026

Being sedentary, when the cervix is short, increases the risk of preterm birth < 34 weeks.

"This prospective study used objective data collection of activity through an accelerometer in patients who are at risk for preterm birth. There was no association between latency to delivery and activity level in patients at risk for preterm birth with a short cervix. This study does not support the use of activity restriction in patients with an increased risk of preterm birth."

Read the full study for FREE at: https://journals.lww.com/greenjournal/fulltext/2026/04000/activity_restriction_in_pregnancy_and_the_risk_of.2.aspx

Listen to the Green Room podcast at: https://journals.lww.com/greenjournal/pages/podcastepisodes.aspx?podcastid=9

27/03/2026

We are attending a 3-day conference on Menopause. We learnt many things:

1. There are many menopausal symptoms that can be effectively treated with hormone replacement therapy.

2. There are different preparations available for hormone replacement therapy - some do not increase the risk of venous thromboembolism and breast cancer.

3. Increasingly, more and more patients are asking to be on hormone replacement therapy for symptoms like hot flushes, prevention of osteoporosis, for sexual dysfunction, and for healthy longevity.

4. The FDA US black box warning on the risks of hormone replacement therapy has been removed in Feb 2026 as the risks stated in the black box warning are now thought to be over-exaggerated.

Soon, at least in Singapore, there will be more menopausal women than pregnant women. All gynaecologists will have to be more well versed with managing perimenopausal and menopausal women.

27/03/2026

Another study to show that doing 2 scans routinely at 28-32 weeks and 35-37 weeks (compared to doing 1 scan at 28-32 weeks only) in low risk pregnancies is better at detecting small for gestational age fetus and reducing admissions to ICU for the newborn baby.

That shouldn’t surprise any of us. This is now one of increasing number of studies showing this.

We do this routinely as T3a (28-32 weeks) and T3b (35-37 weeks).

https://www.facebook.com/share/1LStS8GyLf/?mibextid=wwXIfr

Single versus longitudinal scans in the third trimester: a multicenter randomized clinical trial on screening for late-onset intrauterine fetal growth restriction (The RCT on Evaluation of LAte Iugr Screening study) https://ow.ly/C15l50Yz32q

26/03/2026

Induction of labour (compared to waiting longer either for labour to start spontaneously or eventually requiring an induction of labour later on) in pregnancies where the fetal abdominal circumference or estimated fetal weight is > 90th centile at 38+0 to 38+4 weeks reduces the risk of Caesarean section, and probably the risk of shoulder dystocia as well.

https://www.facebook.com/share/p/1HMmhtakPq/?mibextid=wwXIfr

🚨 Hot off the press from AJOG MFM! 🚨

Can early induction make a difference for pregnancies with suspected large-for-gestational-age (LGA) or macrosomic babies? This new meta-analysis of 5 RCTs (n=4,083) says YES!

✨ Key findings:
• Inducing labor at 38 weeks cut cesarean deliveries by 13%
• Fewer cases of macrosomia (≥4000g and ≥4500g)
• Promising trends: less shoulder dystocia and fewer neonatal fractures
• No rise in major maternal or neonatal complications

🔑 Bottom line: Induction between 38⁰/₇ and 38⁴/₇ weeks is a safe, effective option for LGA pregnancies—about 25 inductions needed to prevent 1 cesarean delivery.

Dive into the full study here: https://ow.ly/T6Uz50YyRjl

21/03/2026

Live ultrasound demonstration at the course.

21/03/2026

Gave 4 lectures in Phnom Penh on:
1. First Trimester Scan - Not just NT only
2. Second Trimester Scan - transvaginal cervical length should be done routinely
3. Third Trimester Scan - diagnosing and managing fetal growth restriction
4. Twin pregnancies - why we need to know the chorionicity.

The participants asked very good questions.

19/03/2026

When the risk of pre-eclampsia at first trimester scan is >= 1:100, aspirin 150 mg every night is given till 36 weeks. When the initial risk is >= 1:20, it is rare to have to deliver such patients at < 35 weeks. When the initial risk is 1:21-1:100, almost all babies will deliver after 37 weeks.

So aspirin works to reduce risk of pre-eclampsia requiring delivery at < 37 weeks.

The effect of aspirin on the risk of preeclampsia based on the Fetal Medicine Foundation first-trimester risk https://ow.ly/H9u650Yw6ze