This is an experience that you would want to undergo in a place that you trust, a warm and caring environment that adds to your delight as you hold your little bundle of joy. Parkway hospitals are widely regarded as amongst the best of the leading private hospitals in Singapore, providing exceptional maternity care in pleasant, private surroundings, with each room equipped with a television, telephone and an attached bathroom. Our maternity patients will enjoy the comfort of an electrically powered delivery bed in each individual delivery suite, plus an accessible nurse call-system and baby resuscitator with warmer to receive your newborn. Each room has a cardiotocography machine that monitors both the mother's and baby's heart rate, and maternal contractions. The unit has a team of caring, dedicated and experienced midwives who work closely with your obstetricians to provide quality care.

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Choosing your room

You have a choice of either a private single bedded or a pleasant two-bedded or a four-bedded (Parkway East Hospital) room. If you choose a single room, your husband can stay overnight with you as a paying lodger (inclusive of meals).

Maternity tours

Just as you will have to get familiar with your new baby over time, we would like you to familiarize yourself with us before the baby's arrival. We conduct tours of the delivery suites and maternity ward so that patients can get to know our staff and facilities before their hospital stay.

Call the following contact numbers to book an appointment for our maternity tours:

• Mount Elizabeth Hospital – (65) 6731-2921 (Client Service Executive)
• Gleneagles Hospital – (65) 6470-5610 / 6470-5615 (Customer Service)
• Parkway East Hospital – (65) 6340-8777 / 6340-8681 (Customer Service)

Our Antenatal class offers:

• Maternal nutrition
• Posture awareness and correction advice
• General foot and leg exercises to stimulate circulation
• Specific exercises for conditioning muscles affected by the pregnancy
• Relaxation training
• Breathing exercise for different stages of labor
• Breastfeeding
• Parent-craft

The programme at Parkway Hospitals is a coordinated, multidisciplinary management of the expectant mother by a team comprising the patient's obstetrician (supported by others like the ultrasonographer and laboratory technician), Lactation Consultants, midwives, dieticians and physiotherapists. Besides the scheduled visits to your obstetrician, expectant parents also attend lessons to prepare for parenthood. The parent-craft nurse will advise the mother-to-be on practical issues, such as making a shopping list of items for the baby, while also preparing her psychologically for the arrival of the baby. Exercises are taught by the physiotherapist to prepare the mothers for labour and childbirth. The dietician will also advise on healthy eating habits and diets for mothers and babies. Midwives and Lactation Consultants give advice on breastfeeding and caring for your newborn.

Your husband is encouraged to attend these sessions together with you. To book a class, call the following numbers:

• Mount Elizabeth Hospital: (65) 6731-2133
• Gleneagles Hospital: (65) 6470-5610 / (65) 6470-5611
• Parkway East Hospital: (65) 6340-8738

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Having a baby is an exciting and joyous experience. Let our expert help you make it even more wonderful.

Mount Elizabeth Hospital is proud to present "Mothers-Get-Together", a session to give you an overview of maternity services and facilities at the hospital. Join us for this interactive session, specially meant for mums-to-be and their spouses.

The Programme includes:

Registration

Visit our exhibition booths and enjoy special promotions for maternity and baby products!

Presentations by Guest Speakers

• Talk by paediatrician
• Talk by haematologist

Interactive Session with Nursing Specialists of Mount Elizabeth Hospital

Find out more about: Ante-natal classes

• Baby care & bath sessions
• Labour of love - baby bonding with father
• Breastfeeding support service
• Baby massage Limousine service upon discharge
• Tour of Delivery Suite Tour of Nursery & Post-Natal Ward

You can choose one of the following Saturday Sessions:

For more information, please contact:

E-mail: pco@parkway.sg
Tel: (65) 6854-6623
Fax: (65) 6854-6667

Pre-register

It is recommended that you visit the hospital about a month before your delivery due date to pre-register. This way, you will not have to worry about registering when you are in labour.

To pre-register, come to the hospital's Admission Counter on Level 2, anytime between 7 am and 8 pm on weekdays with your identity card/passport.

If you are using your husband's Medisave, bring your marriage certificate and his identity card. The reception clerk will pre-register you and give you an envelope of documents, which you have to bring along when you come to deliver your baby.

When to Go to the Hospital?

Discuss with your doctor, ahead of time, when he wants you to go to the hospital. This varies according to the condition of your pregnancy, and whether you have delivered before.

What to Get Ready and Bring along upon admission?

During your stay, the hospital provides a basic toiletries pack for you, as well as vests, wrapping blankets, and a box of tissues for your baby.

Pack your suitcase after your 34th week. Prepare two days' clothing for a normal delivery, and four days' for a caesarean section.

Bring along the following items:

For yourself

• Brassieres
• Nightgowns with front openings (for breastfeeding purposes)
• Maternity towels with loops
• Disposable diapers/wet wipes
• Toiletries for yourself (including slippers)

For Your Husband

• A warm jacket

For Your Newborn

• One baby suit for the day of discharge
• Baby mittens and booties (if you wish)

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When you are in labour - Help us to Help You!

When you are in labour, go to the hospital's Admissions Counter and give the envelope you received from the reception clerk during pre-registration to our staff.

Bring also the lab test results and the letter that your doctor will give you. The letter gives our staff instructions on your delivery procedures. The nurses will then call your doctor and prepare you for delivery.

If you come to the hospital after office hours, or if you are in advanced labour, go straight to the Accident and Emergency (A&E) Department. The nurses will bring you and your husband to the delivery suite immediately.

At the Delivery Suite

The delivery suites at Parkway Hospitals are very accommodating. We believe in family-centre birthing; hence, we encourage your husband to be with you throughout your labour. You and your husband will bond with your baby right from the time your child is born, in the delivery room. As you will see, the unit is fully equipped with all the necessary medical equipment for your delivery. A foetal monitor by your bedside allows you to watch your soon-to-be-born's heartbeat. Nurses can monitor both your and your foetus' condition inside and outside the room.

Once your baby arrives, you and your husband can watch while your baby is checked, bathed and weighed, and this heart-warming scene will definitely be the first of many future happy memories you will have with your child.

You can spend a little quiet time with your newborn, as you will get to hold your baby, before you are transferred to the maternity ward. We recommend that you breastfeed your newborn as soon as possible, while in the delivery room. This may be the perfect time to try to bond with the baby, since most term babies who are born healthy are alert during the first hour or so after birth. The relationship and bond between you and your baby will be further enhanced.

Initiating breastfeeding within one hour of birth is one the Ten Steps to Successful Breast-feeding.

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Parent-Craft Services

All parents, especially young couples, are encouraged to participate. Through these sessions, you will learn various aspects of caring for your newborn, such as:

• How to bathe and maintaining proper hygiene of the newborn – parents are taught methods of identification of common problems in the first week of the baby's life, such as jaundice, skin rashes, bowel problems, and frequent crying
• Care of the baby's umbilical cord stump
• Advice on the baby's vaccinations on discharge

Our lactation consultants will guide you on how to breastfeed successfully and how to cope with your baby during early infancy, as well as teaching you to ensure that the baby's nutritional needs are met.

Breastfeeding Your Baby

We recommend breastfeeding, as breast milk is one of the best gifts you can give to your newborn. Studies show that mother's milk is important for your baby's healthy development, especially in the first few months of your child's life.

Our Lactation Consultants are registered nurses specially trained to help mothers to breastfeed. We encourage you to keep your baby by your bedside, as often as you can, so that you will have every opportunity to bond with your newborn. This would also allow you to do the breastfeeding easier, and without any delay. However, you can leave your baby in the care of the nurses in the nursery, whenever you need some rest. The nursery's large viewing windows allow siblings, relatives, and friends to easily view the new addition to your family.

Why breastfeed?

Breast milk provides your baby with the best possible nutrition. Breastfeeding is convenient – mother’s milk is available anytime baby needs it, and it benefits both baby and mother by enhancing emotional bonding.

What are the benefits for baby?

Breast milk is extremely nutritious, as it contains all the necessary nutrients in the right proportions that your baby needs for growth and development. It protects against infections as breast milk contains antibodies and anti-bacterial factors. Furthermore, it reduces the risk of the baby getting allergies.

What are the benefits for mother?

There are several benefits for the mother. Firstly, she will lose weight faster as breastfeeding burns calories. It also helps the uterus to contract faster and return to a normal size quickly. Breastfeeding also calms and relaxes the mother, as the action of breastfeeding releases hormones from the brain, giving the mother a sense of well-being.

Studies have also shown that mothers who breastfeed have a reduced risk of developing breast and ovarian cancer.

Another benefit is that while you are providing the best possible nutrition for baby, you are also saving money, as breast milk is free.

How important is the mother's nutrition during breastfeeding?

Naturally, while a mother is breastfeeding, she should eat a well-balanced diet in order to help her body provide the best possible milk for the child. Also, the mother should drink according to her thirst, and not take too little or too much liquids.

When to get started?

It is important to start breastfeeding early. The earlier you breastfeed your baby, the sooner you will establish milk production. If you have had a caesarean delivery, you can breastfeed when you are fully awake and ready to do so. The maternity care team is committed to supporting you while you breastfeed.

How do I know my baby is sucking or attached to my breast correctly?

• Your baby’s mouth is wide open and covers as much of the areola as possible, with the lower lip turned out
• Your baby’s chin is touching your breast
• Your baby’s jaws are moving rhythmically
• There is no clicking sound
• Your baby’s cheeks are not drawn in

Where to get help?

Breastfeeding classes are held daily (except Sunday) to assist you with practical advice and information on breastfeeding your baby. There are experienced nurses offering round-the-clock support whenever you need help.

We also run an in-house TV programme on breastfeeding; newborn bathing; care for the baby's cord and diapers changing.

For more information or assistance with difficulties you may be experiencing with breastfeeding, please call the individual hospitals' customer services line to make an appointment with our lactation consultant. There is a fee chargeable for each consultation. In addition, the cost of using a breast pump during the session is S$10 (prices exclude GST).

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What is Newborn Screening?

Newborn screening is tests performed on every baby during the first few day of the baby's life. Screening is done to detect any serious birth defects even if the newborn seems healthy and has no apparent symptoms of health problems.

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What diseases are newborns screened for?

The following are offered to our newborn at our hospitals

• G6PD deficiency
• Congenital Hypothyroidism
• Hearing Defect (OPTIONAL)
• Inborn Metabolic Error (OPTIONAL)

Talk to your Obstetrician and Paediatrician for further advice. This newborn screening programme for genetic, endocrine, and metabolic disorders identifies newborns who may be at risk for one or several serious diseases. If left untreated, these diseases can lead to slow growth, blindness, mental retardation, and possibly death. Detecting these problems early and providing appropriate treatment may prevent many serious complications from developing later.

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The Neonatal Intensive Care Units (NICUs) of Parkway’s Hospitals are designed to provide tailored medical care to newborn infants that are premature or ill. Premature babies and other vulnerable babies benefit from the latest state-of-art equipment and skills of the dedicated staff at the Parkway Neonatal Units. Ventilators used include pressure control ventilators, jet high frequency and high frequency oscillatory ventilators. Other devices include infusion pumps, syringe drivers, the Pulse Oximeter, and a blood gas machine.

The quality and skill level of our medical staff and the wide scope of our equipment ensure that we can take care of critically ill infants. Our nurses are experienced and specially trained to work with our Neonatologists in caring for the NICUs' tiny babies using a multidisciplinary team approach. The warmth, commitment, and compassion of our caregivers are as forthcoming as ever. Parents are encouraged to visit their baby for bonding. Visitation is open to parents in the NICUs. Parents may take pictures, so as to allow family members and friends who are not permitted to visit the NICU, to see the baby.

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For your convenience, registering the birth of your child can be done at all the three hospitals. All you need to do is to complete form BD 13-11/96, which can be obtained at the Main Admissions Counter.

You just have to bring the completed form, together with the identity cards of you and your spouse, your original marriage certificate and a copy of the Birth Notification, which is given to you by the nurse at the time of your child's birth. The ward clerk or the nurses will direct you to the counter to undergo the administrative procedures required to obtain a Birth Certificate for your child. The fees for the Birth Registration, inclusive of administrative charges, are S$28.30. Only cash payments are accepted.

You can also register your child's birth at the Immigration & Checkpoints Authority ICA (formerly known as Singapore Immigration & Registration) office located at:

Registry of Births & Deaths

Citizen Services Centre
3rd Storey, ICA Building
10 Kallang Road (next to Lavender MRT station)
Singapore 208718

You may visit the ICA's website www.ica.gov.sg for more information.

Please note that births should be registered within 14 days from the date of birth (including Sundays and public holidays). Registrations done after 42 days require a letter of explanation to the ICA stating the reason for late registration.

If you are a Permanent Resident or Non-citizen, you will be required to produce your Re-Entry Permit/Employment Pass.

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Postnatal Exercise Classes

We have a specially designed exercise regime, to help new mothers shed those extra pounds from pregnancy, as well as tightening abdominal and pelvic muscles.

Baby Massage Programme

Touch is a physical expression of love, and is especially important for infants and children. Baby massage promotes parent-child bonding, calms the child, and promotes sleep. It also elevates infant gas and colic, and encourages muscular coordination and suppleness, which prepares babies for various activities.

In our baby massage class, you will learn the benefits of baby massage, while practicing the right massage techniques under the guidance of a qualified therapist.

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Home Care Service

New mothers often feel worried and apprehensive about taking care of newborns. Our homecare services are a great help and comfort to you and your family. Our skilled nurses will visit you and your baby at home and help with:

Baby

• Bathing your newborn
• Umbilical cord care
• Helping you identify and care for jaundice, rashes and temperature monitoring
• Baby hygiene
• Feeding and sterilising milk bottles and utensils

Mother

• Advice and care in breastfeeding
• Perineal and caesarean wound care
• Toning exercises
• Hygiene

For more information on our home care services, please contact our various hospitals:

Mount Elizabeth Hospital - (65) 6738-9727
Gleneagles Hospital – (65) 6738-9727
Parkway East Hospital – (65) 6340-8681

Postnatal Massage

Postnatal massage is recommended after childbirth. Besides relaxation, it promotes blood circulation, improves sleep, and reduces stress. It also helps digestion, eliminates toxins, improves the lymphatic system, eases muscle aches and pains, exfoliates old skin cells to renew and rejuvenate your skin, and most importantly, regain your figure!

You will experience an hour-long full body massage using herbal and aromatherapy massage oil from head to toe, in the privacy of a cosy room at the hospital. Traditional Malay postnatal massage has long being recognized for its benefits. Our masseuse has many years of experience, and is also certificated in Swedish massage. Many women have experienced it and seek this form of massage to restore their beauty and health after childbirth. You should try it too! (Note: This service is NOT available for Patients on Caesarean Delivery and is only available to mothers who have delivered at East Shore Hospital.)

For more information, please contact:

Parkway East Hospital, Singapore
Maternity Ward 3A
Tel: (65) 6340-8681

Prenatal Pilayoga

Prenatal Pilayoga It is a low intensity, holistic exercise programme which prepares pregnant women to manage the stress and hard work of carrying a baby to term, as well as during delivery. It teaches correct breathing techniques and body posture, and aims to achieve mind and body relaxation so as to ease labour pains.

Some of the problems that pregnant women encounter may include the increase of blood pressure, increased loads to the spine, resulting in back pains. Also, hormonal changes during pregnancy may affect mood swings and sleep patterns.

This class is open to all expectant mothers who have passed their first trimester (first 14 weeks of pregnancy). Each session is one hour long, and is guided by a fitness instructor who has more than 15 years of experience.

Benefits

The benefits of baby massage and practicing the right massage techniques under the guidance of a qualified therapist are:

• Relieves stress and increases ability to control mood changes
• Improves blood circulation
• Strengthens the back and pelvic floor muscles, which can be helpful during and after delivery
• Strengthening the pelvic floor muscles also helps to prevent post-natal complications such as urinary stress incontinence (inability to hold your urine) and uterus prolapse in old age
• Tones and strengthens the entire body to help the mother get back into shape after delivery
• Corrects breathing techniques to reduce labour pain

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What are Uterine Fibroids?

Uterine fibroids are lumps that grow on your uterus.

Fibroids can grow on the inside of the uterus, within the muscle wall of the uterus, or on the outer surface of the uterus. When the size of a fibroid is large, it can change the shape of your uterus.

Uterine fibroids are non-cancerous growths in the uterus and are also called fibromyomas, leiomyomas or myomas.

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What is the function of a uterus?

The uterus is a hollow, pear-shaped organ in a woman's lower abdomen in which a foetus (baby) grows during pregnancy. When a woman is not pregnant, her monthly menstrual period flows from the uterus.

What causes fibroids?

Medical researchers still do not know what causes fibroids to develop. However, there is evidence that the female hormones, oestrogen, and progesterone, can make them grow. During pregnancy, when hormone levels are fluctuating, fibroids tend to increase in size. During menopause, hormone levels are low and stable, the fibroid stops growing and may even become smaller.

When should you seek treatment for fibroids?

If you are experiencing the following symptoms, do seek treatment as soon as possible as they indicate the presence of a large or multiple fibroids:

• Discomfort or pain during sexual intercourse (This is a significant symptom which should be mentioned to the gynaecologist)
• Excessive vaginal bleeding; passing of blood clots or prolonged menstrual period
• A sense of pressure or discomfort in the lower abdomen or pelvis
• The need to urinate frequently or inability to urinate despite a full bladder
• Acute abdominal pain or chronic and mild but persistent localised pain
• Constant back pain (as fibroids can press against the muscles and nerves of the lower back)
• Difficulty in movement of bowels (as fibroids can cause rectal pressure and a feeling of rectal fullness)

Treatment for fibroids

The obstetrician may suggest frequent ultrasound scans to ensure that there are no significant changes or developments, and that the fibroids are not growing.

In women whose fibroids are large or are causing significant symptoms, treatment may be necessary. Treatment will be determined by your physician(s) based on your age, overall health and medical history, the sizes of the fibroids, and your desire for future pregnancy.

Non Steroidal Anti Inflammatory Drugs

Those having mild pain may be asked to take NSAIDs (Non Steroidal Anti Inflammatory Drugs). In some cases, exercise and a change in diet may be the only treatment needed.

GnRH Hormonal Treatment

Non-surgical techniques are usually hormonal in nature, and include the use of drugs that turn off the production of oestrogen from the ovaries.

This hormonal treatment may delay fibroid treatment until after menopause, when symptoms sometimes become less severe, or disappear spontaneously. GnRH agonists are used to shrink the fibroid, making surgical treatment easier. It lowers the levels of oestrogen from the ovaries, causing "medical menopause". These medications are given for three to six months. When successful, they can shrink the fibroids by as much as 50%.The shrinkage is temporary and gives menopause-like symptoms such as hot flashes, mood swings, insomnia, sexual dysfunction, and premature bone mineral loss.

Uterine fibroid embolization

This also sometimes called Uterine Artery Embolization (UAE). It is a newer, minimally-invasive technique. A small, thin catheter is inserted through the groin and threaded into the arteries supplying blood to the fibroids. A compound is injected into the arteries with guided x-rays to block the blood and oxygen supplies. This would cause the fibroids to shrink and die.

UAE for fibroids have a shorter hospital stay than those having surgery, but a greater risk of complications with the compound used. Studies are underway to evaluate the long-term outcomes of UAE as opposed to surgical treatment.

Endometrial Ablation and Resection

In this procedure, a gynaecologist places a scope, through the cervix into the uterine cavity, to burn and scrape the lining of the uterus. The removal of the lining (endometrial ablation) stops heavy bleeding. Like a hysterectomy, this fibroid treatment causes permanent infertility. Large fibroids cannot be removed by this procedure.

Abdominal hysterectomy

This is the surgical removal of the uterus. It is the most common treatment for fibroids. A hysterectomy is usually performed through an incision in the abdomen. Sometimes, the ovaries are removed in addition to the uterus and cervix. The decision to remove the ovaries depends on the ovaries' medical condition and the woman's age.

Vaginal hysterectomy

Sometimes, for smaller fibroids, the uterus can be removed through the vagina. After a vaginal hysterectomy, the only stitches are inside the vagina. The body absorbs the stitches in four to six weeks.

Laparoscopic-assisted vaginal hysterectomy

A surgeon may perform a vaginal hysterectomy assisted by laparoscopy.

Abdominal Myomectomy

The surgeon makes an incision in the abdomen, exposing the uterus, and fibroids are excised from the uterine wall muscle. This abdominal incision would enable the surgeon to visualise and remove multiple fibroids.

Laparoscopic Myomectomy, which is less invasive, is sometimes possible, and has a much shorter recovery time.

Hysteroscopic Myomectomy

A lighted tube (hysteroscope) is inserted though a small incision in the abdomen. This procedure helps the surgeon to view the fibroids and remove them. This procedure can only remove fibroids located inside the uterus.

Myomectomy is a conservative surgical procedure. The fibroids are removed but the uterus is left intact to enable a child-bearing potential. This is usually the preferred fibroid treatment for younger women desiring to keep their fertility. However, on average, the procedure results in more blood loss. Like hysterectomy, myomectomy requires general anaesthesia, coupled with and a long recovery time.

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What is endometriosis?

Endometriosis occurs when the tissue that lines the uterus grows beyond or outside the uterus. It commonly grows on the ovaries, behind the uterus, or on the bowels or bladder. The cause of endometriosis is unknown.

Endometriosis causes infertility and very heavy periods. The pain is usually in the abdomen, lower back or pelvic areas.

Some women have no symptoms, but difficulty in conceiving may be the first sign.

Why does endometriosis cause infertility?

Endometriosis and infertility are related to structure distortions such as tubal blockage and adhesions. Endometriosis may create an environment in the local abdominal cavity that is hostile to egg fertilization and embryo development.

Can I prevent it?

There are no known ways to prevent endometriosis, because the cause is not clear. However, researchers have found that there are several factors related to endometriosis:

• Chances of developing endometriosis are seven to 10 times higher if there were previous occurrences in the family
• The menstrual cycle is consistently close (within 25 days)
• The menstrual flow during each period lasts more than a week
• The menstrual flow is heavy during each period
• There is a congenital anomaly of the uterus, such as a double uterus, or a double cervix

What types of treatment are available?

• Treatment depends on the severity of your symptoms and your conception plans. If you have endometrial pain or bleeding and there are no immediate plans to conceive, hormone therapy* can be used to lower your body's oestrogen levels. This will shrink the endometriosis tissue. Pain can be controlled with anti-inflammatory medication. Other combinations of hormone therapies may be required.

Points to note:

• Hormone therapy for endometriosis prevents conception.
• Treatment for infertility relating to endometriosis is complex. If you have a lot of endometriosis pain and you are planning to become pregnant, laparoscopy is likely to be your gynaecologist's first choice for pain relief. Sometimes a laparoscopy is done to look for the location and severity of endometriosis.

If I do not plan on getting pregnant, should I use hormone therapy OR surgery to treat my endometriosis?

When hormone therapy does not work or if tissue growth is affecting other organs, surgery to remove endometrial growths and scar tissue will be the next step.

Surgery is usually done using laparoscopy, where one or several small incisions are made on the abdomen. After surgery, you may continue with hormone therapy to prevent endometriosis from coming back.

In recurrent or severe cases, removing the uterus and ovaries is another option for patients who are not planning to conceive. These surgeries may cause early menopause.

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What is urinary incontinence?

Urinary incontinence is the involuntary loss of urine that causes the individual social and hygiene problems.

Urinary incontinence can develop at any age. As we get older, poor bladder function becomes more common because of weakening of pelvic floor muscles and other medical conditions. However, very few women with such problems seek treatment because of the lack of knowledge that simple surgery can be done to stop this discomfort and embarrassment. There are many treatments available, and most cases of urinary incontinence can be improved or even cured.

When do you seek treatment for urinary incontinence?

A healthy person will empty his bladder every three to four hours (four to eight times in 24 hours). You should seek treatment if you get up more than once at night to, or if you are not able to hold your urine before you reach a nearby washroom.

What are the common causes?

• Childbearing can stretch the pelvic muscles that hold organs in place and damage the nerves and tissue around the bladder's neck
• The position of the uterus, bladder, and bladder neck in the abdomen can also change and affect your ability to control your bladder
• The drop in oestrogen that occurs during menopause can weaken pelvic and vaginal muscles and tissues, and increases the likelihood of incontinence

What are the types of urinary incontinence?

Acute Incontinence is usually related to a medical problem. It disappears once the illness is treated or resolved. For example, urinary tract infections can cause loss of bladder control, and certain medications, such as sedatives and diuretics, can relax bladder muscles, thereby possibly leading to urinary incontinence. Urinary incontinence can also be caused by a lack of oestrogen. In that case, hormone replacement may resolve the problem.

Chronic Incontinence is a long-term loss of urine control. It may be due to changes in the bladder and urethra, or a result of damaged pelvic muscles and nerves. Multiple pregnancies or aging can cause pelvic organs to shift and interfere with bladder function.

What are the common types of chronic incontinence?

Stress incontinence is described as urine leakage in small amounts during activities such as coughing, laughing, sneezing, or exercising

Urge incontinence is having a frequent and urgent need to urinate. The urge to urinate is so strong that the individual often has urine leakage before reaching the washroom. This is a common amongst older adults. The nerve or muscles of the bladder may be damaged due to a urinary tract infection, surgery, tumours, Parkinson’s disease, multiple sclerosis, or stroke.

Overflow incontinence happens when small amounts of urine leak throughout the day. When passing urine, the stream of urination may be weak, and you may feel that the bladder is never fully emptied. It can be caused by a blockage at the urethra or the bladder being unable to contract properly. The blockage could be due to a prolapsed uterus (lump protruding out of vagina). It could also be due to muscle or nerve dysfunction that prevents the brain from receiving messages from the bladder to urinate. The use of smooth muscle relaxants, such as antidepressants, could be another reason that dulls the sensation to pass urine.

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What is menopause?

Menopause represents the end of menstruation cycles. It is usually diagnosed when a woman has not had a menstrual period more for than a year, and there are no other obvious medical issues. A majority of women experience natural menopause between the ages of 45 to 55, but it can occur as early as age 30, and as late as age 60.

Menopause is not a disease; rather, it is a natural progression to the end of a woman’s fertility, resulting from the slowing down of production of the two sex hormones, oestrogen and progesterone, in the ovaries. The discomfort of menopause varies and can be frustrating. However, a positive mindset would help ease many of the discomforts.

What are the signs and symptoms?

The experience of menopause varies from woman to woman. Menopausal women tend to find life more overwhelming than normal, and do not understand why this is so. The mood of a menopausal woman changes frequently with high occurrence, ranging from feelings of sadness to irritability and frustration. These are normal hormonal changes that may happen but can be dealt with.

Other common symptoms include:

• Hot flashes - they result from hormonal fluctuations and imbalance, and usually occur at night, which can be annoying and uncomfortable; these hot flashes may interrupt the sufferer's normal sleeping cycle, leading to insomnia and fatigue
• Thinner and more sensitive vaginal lining
• Vaginal dryness, painful intercourse, bladder incontinence, and a bloated body due to water retention.
• Higher risk of urinary tract infections
• Weight gain around waist or mid-section of the body

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We pamper our young patients. We hold their hands through treatment, and make them feel at ease. The young patients in our paediatric ward, ranging in age from newborn babies to 16 years, are certainly well looked after. What also makes a difference in our care is the personalised touch. Our experienced and dedicated staff are ever ready to attend to your children's needs and make their stay comfortable. For example, we are flexible on medication and visiting times. Nursing staff, donning colourful aprons, will always go the extra mile to make the children's stay comfortable. The nursing staff, working closely with the paediatricians, form a supportive and effective medical team.

Parents are encouraged to stay with their children throughout their hospitalization at no extra charge, with free meals being provided for parents.

The ward comprises a dedicated inpatient paediatric unit, featuring tastefully decorated private rooms specially designed to provide the best setting for a child to recover. The unit is well equipped to handle a broad range of general and paediatric surgeries for medical conditions such as cancer, tonsillitis, appendicitis, sinus, asthma, allergies, bone deformities, and ear, nose and throat (ENT) problems.

With the latest technology, and under the expert care of our team of specialists and dedicated staff, our young patients recover in good time, and are able to return quickly to their daily lives. At Gleneagles Hospital, a paediatric intensive care unit (ICU) is also available. Day care treatment, including chemotherapy and observation, are available in East Shore Hospital.

What are the common types of Congenital Heart Disease?

• Atrial Septal Defect (ASD)
• Ventricular Septal Defect (VSD)
• Patent Arterial Duct (PAD)
• Pulmonary Stenosis
• Aortic Stenosis
• Mitra Valve Prolapse
• Coarctation of Aorta
• Fallot’s Tetralogy
• Transposition of Great Arteries
• Pulmonary Atresia
• Other Complex Congenital Heart Diseases

What diseases are newborns screened for?

The following screening examinations are offered to newborns at our hospitals:

• G6PD deficiency
• Congenital Hypothyroidism
• Hearing Defect (OPTIONAL)
• Inborn Metabolic Error (OPTIONAL)

Do consult your Obstetrician and Paediatrician for further advice. This newborn screening programme for genetic, endocrine, and metabolic disorders identifies newborns who may be at risk for one or several serious diseases. If left untreated, these diseases can lead to slow growth, blindness, mental retardation, and possibly death. Detecting these problems early and providing appropriate treatment may prevent many serious complications from developing later.

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What is G6PD?

G6PD is an enzyme in the body which helps red blood cells function normally.

What is G6PD deficiency?

G6PD deficiency is an inherited condition in which a person's body does not have enough of the enzyme.

The enzyme helps to strengthen the red blood cell walls. When deficient, the red blood cells break down more easily, thereby producing more bilirubin, which in turn causes jaundice.

How is this being detected?

A sample of cord blood is collected before the delivery of the placenta. A simple test is done to confirm the diagnosis.

What if my child is G6PD deficient?

Your baby may have to stay in the hospital a little longer for monitoring of Jaundice levels.

This deficiency can cause anaemia. Anaemia usually happens after bodily exposure to certain chemicals, medicines, herbs, and beans, which make red blood cells break down easily.

What is going to happen to my child?

This condition is permanent.

Avoid giving drugs to your child that are not prescribed by the doctors. Also avoid herbs and beans such as san zi zi, fava beans and chuan lian. A list of other common medicines to avoid can be obtained from the hospital.

Breastfeeding mothers should not take any of the above either as the chemicals can reach the baby through the mother's breast milk.

Apart from observing these precautions, your child can live a normal life.

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What is Congenital Hypothyroidism?

Congenital hypothyroidism is a condition in which there is an inadequate production of the thyroid hormone. The cause may be total or partial failure of the development of the thyroid gland.

How is this being detected?

A sample of cord blood is collected before the delivery of the placenta. A simple test is done to confirm the diagnosis.

What could happen to my baby if it is not treated?

If the condition is not treated, severe mental retardation, growth delays, deafness, and other neurological abnormalities can occur.

What is the treatment?

To treat congenital hypothyroidism, thyroid hormones are given daily in most cases. The baby's growth and development is assessed, and thyroid function is evaluated periodically.

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Why is the screening important?

The first six months of a baby’s life are the most important, particularly in terms of speech and communication development.

This screening programme has now become a standard of care for neonates in Singapore, given that severe hearing loss is present in 0.18% of newborns in our population.

When hearing defects are identified at an early stage, relevant support and information can then be provided for you, so as to obtain better treatment outcomes.

How is hearing screening done?

The screening method is simple, safe and painless. It involves placing small sensors on the baby’s head and presenting quiet clicking sounds through specially designed headphones. The computer analyses the responses to the sound. The test is usually done before your baby leaves the hospital.

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What is Inborn Metabolic Errors?

Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. It increases the risk for stroke, cardiovascular diseases, and diabetes, which are major causes of morbidity and mortality throughout the world. Early identification and intervention may delay and even prevent the occurrence of these diseases.

How is my baby screened?

A tiny amount of blood is taken from your baby's heel, and placed on a special type of filter paper. Then, a tandem mass spectrometry is use to detect the blood's components. The technology is capable of detecting more than 20 inherited disorders. This technology is increasingly used for these types of diagnoses.

Additional diagnostic tests are necessary to determine what disorders are present if the infant presents with an abnormal test result.

When is the screening done?

Samples from babies should ideally be collected between 24 and 48 hours of age.

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