HELMS Journey - Pregnancy

Congratulations on your pregnancy! You’ve reached the next phase of your HELMS journey. The booking visit is crucial for us to do a scan for the baby and determine your estimated date of delivery (EDD). We will also be performing baseline screening for you and your partner.

• Measure height, weight, blood pressure, and do a urine test
• Review diet and level of physical activity
• Perform basic history taking and physical examination
• Review ultrasound dating scan and determine EDD
• Perform antenatal blood tests, including FBC and Hb electrophoresis, blood group
• Full blood count and Hb electrophoresis: Identify underlying anemia or low Hb, which would require iron supplementation
• Blood group and Rhesus screening: Determine blood group and Rh status, if Rh negative, you will require Rhogam between 28 to 32 weeks
• Infection screening: Screen for Hepatitis B, Syphilis and human immunodeficiency virus (HIV)
• Rubella immunity screening: Screen for Rubella immunity, if not immune, you should receive MMR vaccination after pregnancy
• Perform eye assessments
• Provide necessary supplements
• Give vaccination – influenza
• Counsel about Down Syndrome screening (DSS)
• Review symptoms
• Collect stool

Down syndrome, or trisomy 21, is the most common chromosomal abnormality (1 in 700 births) and the most common cause of learning disability. In addition to learning disability, Down syndrome is associated with other medical conditions such as heart defects, gastrointestinal issues and a reduced muscle tone.

There are 2 main forms of screening:

1. First trimester screening (FTS)
2. Non-invasive prenatal test (NIPT)

Your obstetrician will discuss the details of the tests with you, and you can decide which test you want.

• Measure height, weight, blood pressure, and do a urine test
• Perform blood test for DSS if not already done and/or NIPT
• Review ultrasound scan and blood test for DSS

Almost there! Your baby should be about the size of an avocado by now! As you transit into your second trimester, be prepared to see your doctor once every 4 weeks. You may need more visits to your doctor if you have a complication identified.

• Measure height, weight, blood pressure, and do a urine test
• Perform basic history taking and physical examination
• Perform fetal doptone
• Review antenatal blood tests and DSS results
• Perform antenatal blood tests if not done already
• Provide necessary supplements
• Give vaccinations – influenza and TDaP if not already done
• Review symptoms

Congratulations on reaching the 2nd half of your pregnancy!

At this point in time, your baby is around the size of a mango and would weigh about 300g. Over the next few weeks, your body will undergo more changes and you may feel symptoms of fatigue and back pain as your baby grows.

This is an important visit where we will be doing a detailed scan for your baby to check for any structural problems.

• Measure height, weight, blood pressure, and do a urine test
• Perform basic history taking and physical examination
• Review ultrasound screening scan results
• Provide necessary supplements
• Give vaccinations – influenza and TDaP if not already done
• Review symptoms
• FBC and oral glucose tolerance test (OGTT) at the next visit (to come fasted)

Welcome back to your second HELMS visit! You are now in your 2nd trimester and your baby would be around the size of a papaya by now and will weigh around 500g. Remember to come fasted for this visit as we will be checking your glucose (blood sugar) profile.

• Measure height, weight, blood pressure, and do a urine test
• Review diet and level of physical activity
• Perform basic history taking and physical examination
• Perform fetal doptone
• Do OGTT and FBC
• Provide necessary supplements
• Give vaccinations – influenza and TDaP if not already done
• Review symptoms
• Collect stool

Congratulations on reaching the final leg of the journey! The third trimester begins now. At this point in time, your baby is around the size of a brinjal, weighing around 1 to 1.5kg

This is an important visit where we will be doing a scan to check on your baby’s growth.

• Measure height, weight, blood pressure, and do a urine test
• Perform basic history taking and physical examination
• Review OGTT and FBC results
• Review ultrasound growth scan results
• Provide necessary supplements
• Give vaccinations – influenza and TDaP if not already done
• Review symptoms

You are almost there! Your baby should be about 2kg in size now. During this visit, we will do the routine tests and make sure you are all prepared for delivery in about 2 months’ time.

• Measure height, weight, blood pressure, and do a urine test
• Perform basic history taking and physical examination to assess position and growth of the baby
• Perform fetal doptone
• Provide necessary supplements
• Give vaccinations – influenza and TDaP if not already done
• Review symptoms

Welcome back to your third and final HELMS visit this pregnancy! Your baby would be about 2.5kg at this point. This is an important visit for us to discuss the timing and mode of delivery, as well as to screen for Group B Streptococcus (GBS).

• Measure height, weight, blood pressure, and do a urine test
• Review diet and level of physical activity
• Perform basic history taking and physical examination to assess position and growth of the baby
• Perform eye assessments
• Perform fetal doptone
• Discuss the timing and mode of delivery
• Perform low vaginal swab (LVS) to screen for GBS
• Provide necessary supplements
• Review symptoms
• Collect stool

You are full term now! That means you may start showing signs of labour such as regular contractions, show or leaking liquor (amniotic fluid). Do come to the hospital immediately if that happens.

Your baby should be about 2.5 to 3kg in size now.

• Measure height, weight, blood pressure, and do a urine test
• Perform basic history taking and physical examination to assess position and growth of the baby
• Perform fetal doptone
• Discuss the timing and mode of delivery, and labour analgesia
• Review LVS result for GBS
• Perform vaginal examination to check the cervical changes for labour
• Provide necessary supplements
• Review symptoms

You have reached your due date! This means that we should be planning for delivery right about now. If you have not gone into labour yourself, your doctor will discuss induction of labour with you.

Your baby should be about 2.5 to 3kg in size now.

• Measure height, weight, blood pressure, and do a urine test
• Perform basic history taking and physical examination to assess position and growth of the baby
• Perform fetal doptone
• Discuss about the timing and mode of delivery, and labour analgesia, and decide on planned date for delivery
• Perform vaginal examination to check the cervical changes for labour
• Provide necessary supplements
• Review symptoms