Tony Tan Women and Fetal Clinic

24/11/2025

Interesting

Prepregnancy metformin use associated with lower risk of severe nausea and vomiting of pregnancy and hyperemesis gravidarum - Model and potential prevention strategy
A, When GDF15 levels are low before pregnancy because of genetics and other factors, then the patient may be hypersensitive to the rise in GDF15 during pregnancy and at increased risk for severe nausea and vomiting and hyperemesis gravidarum. B, When GDF15 levels are high before pregnancy because of prepregnancy metformin treatment and other factors, then the patient may be desensitized to the rise in GDF15 during pregnancy and at low risk for severe nausea and vomiting and hyperemesis gravidarum. https://ow.ly/V22u50XwvRX

22/11/2025

The RELAIS trial in Italy showed that routinely doing 2 scans at 28-32 weeks and 35-37 weeks vs just routinely doing 1 scan at 28-32 weeks resulted in better detection of small babies at birth (20% vs 0%).

That’s what we have been doing.

Undiagnosed fetal smallness is strongly associated with adverse perinatal outcomes. Despite robust evidence that late third trimester ultrasound improves small for gestational age detection the question of whether routine ultrasound assessment in late pregnancy can improve perinatal outcome remains....

22/11/2025

https://www.facebook.com/stories/10157562399557236/UzpfSVNDOjEzMjUyMTAwMTg5MDY2MjI=/?view_single=1&source=shared_permalink&mibextid=wwXIfr

21/11/2025

The new SMFM Consult Series #74:Cell-free DNA screening for aneuploidies: Updated guidance provides updated guidance on the evolving applications of cell-free DNA (cfDNA) screening, including its use in detecting s*x chromosome aneuploidies and microdeletions and its application in multifetal gestations.

Read the complete consult and access the visual summary here: https://publications.smfm.org/publications/620-society-for-maternal-fetal-medicine-consult-series-74cell/

19/11/2025

This amazing lady has 7 children in Singapore!

https://st.benesse.ne.jp/ikuji/content/?id=210869po

『世界ふしぎ発見』や『世界ウルルン滞在記』の元レポーターであり、現在はシンガポールを拠点にアーティストとして活動する、山口日記さん。2011年、結婚と同時にシンガポールへ移住し、そのあとに6人の子どもを年子....

13/11/2025

sFlt1/PlGF useful for pregnant patients with hypertension who are admitted.

Real-world evidence for the utility of serum soluble fms-like tyrosine kinase 1/placental growth factor test for routine clinical evaluation of hospitalized women with hypertensive disorders of pregnancy https://ow.ly/AVlg50Vxhfe

13/11/2025

🤰 Some parents carry quiet worries from a previous pregnancy. Others wonder if past complications might return. These concerns are real, and they often linger even before the first prenatal check.

At our upcoming seminar 𝐉𝐨𝐮𝐫𝐧𝐞𝐲 𝐭𝐨 𝐏𝐚𝐫𝐞𝐧𝐭𝐡𝐨𝐨𝐝: 𝐇𝐢𝐠𝐡-𝐫𝐢𝐬𝐤 𝐏𝐫𝐞𝐠𝐧𝐚𝐧𝐜𝐲, 𝐁𝐫𝐞𝐚𝐬𝐭𝐟𝐞𝐞𝐝𝐢𝐧𝐠, 𝐚𝐧𝐝 𝐂𝐚𝐫𝐢𝐧𝐠 𝐟𝐨𝐫 𝐘𝐨𝐮𝐫 𝐂𝐡𝐢𝐥𝐝, Dr Tony Tan Tony Tan Women and Fetal Clinic will share how careful monitoring, early detection, and personalised planning can make a meaningful difference in pregnancy outcomes. No two pregnancies unfold the same way, and understanding what to look out for can help parents approach the journey with confidence.

Tag a friend who is expecting, and join us to learn more about caring for both mother and baby 🩷
To attend the seminar, register at https://mtalvernia.sg/prenatal-seminar-registration/

13/11/2025

Some placental lesions are more commonly found in pregnancies with fetal growth restriction. These may show up as abnormal umbilical artery Doppler findings or decreased cerebroplacental ratio.

https://ow.ly/YzZC50XqX9Cl o

03/11/2025

29% of preterm premature rupture of membrane (PPROMs) < 32 weeks were found to have intra-amniotic infection. 61% of these infections were due to the bacteria Ureaplasma.

This would mean that we have to change our antibiotics that we give for PPROMs < 32 weeks. Azithromycin was initially thought to be better but this centre uses oral clarithromycin to treat the Ureaplasma.

Can use clarithromycin 500 mg bd for a week.

Preterm prelabor rupture of membranes: the use of amniocentesis to detect intraamniotic infection reduces maternal and neonatal duration of antibiotic exposure https://ow.ly/3AKC50XlrSu

02/11/2025

Pregnant women >= 35 years old and < 20 years old have increased risks of non-chromosomal anomalies of the fetus. Detailed ultrasound scans at 20 weeks may be able to detect some of these anomalies that are structural in nature, but not the non-structural anomalies.

Previously, data only showed that advanced maternal age increases risk of chromosomal abnormalities.

https://www.facebook.com/share/p/1KzrM4SPnU/?mibextid=wwXIfrn n l led ne lrlkomall

Very young and advanced maternal age strongly elevates the occurrence of nonchromosomal congenital anomalies: a systematic review and meta-analysis of population-based studies https://ow.ly/j2aX50TXTEI

25/10/2025

Attended the 11th Asia Pacific Fetal Therapy Conference in Shenzhen. Chaired a session on therapy in multiple pregnancies. Remembered that I attended the 1st Asia Pacific Fetal Therapy conference in Hong Kong as well.

24/10/2025

At the student forum today, the students presented 2 cases:
1. Case 1 - a case of a baby born with albinism, and on further investigation, the parents found out that they were first cousins. I learnt that marrying a relative or adopted relative within 3 generations is illegal in China. This position has already been relaxed from ancient laws where one cannot marry another with the same surname. Despite this, consanguineous marriages still occur in 1.4% of Han population and up to 14-15% in minority ethnicities like Yi population.
2. Case 2 - a case of a baby with Angelman syndrome born to a celebrity couple in China. 70% of babies with Angelman syndrome are due to a de novo microdeletion of the maternal copy of the chromosome 15q11-q13. This may be detected with NIPT such as the extended Panorama test. The other 30% are due to imprinting disorder, uniparental disomy or mutation. These will not be detected with NIPT. Whilst amniocentesis with chromosomal microarray (CMA) test may detect the microdeletion, the methylation test may detect the microdeletion, imprinting disorder and uniparental disomy. However Angelman syndrome due to mutations of UBE3A gene will be missed by both the CMA and methylation test. Such mutations could be detected with the whole exome sequencing.