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Gestational Age
Expected Due Date
| No. | Specialist in-charge | Klinik Kesihatan |
|---|---|---|
| 1. | Dr Azzry Bin Mohamad |
|
| 2. | Dr Munirah Binti Aminullah |
|
| 3. | Dr Farah Hana Binti Mohamod |
|
Kandungan akan dikemaskini...
O&G Hospital Segamat provides detail scan service during Antenatal Clinic. The service will be run by an O&G Specialist from Hospital Segamat under the direction of a visiting MFM consultant from Hospital Sultanah Aminah (HSA), Johor Bahru.
| No | Condition | Detail scan referral |
|---|---|---|
| Current/Index Pregnancy | ||
| 1 | Suspected fetal anomalies | As soon as the condition is detected |
| 2 | Monochorionic twins | Once chorionicity has been confirmed |
| 3 | High order multiple pregnancy | As soon as the condition is detected |
| Pre-existing Maternal Condition | ||
| 4 | Alpha thalassaemia (carrier/major) especially if spouse also has alpha thalassaemia | As soon as the condition is detected, as there is a role for prenatal diagnostic procedure |
| 5 |
DM/GDM
|
Please call early for appointment between 20-24 weeks |
| 6 | Hyperthyroidism or Hypothyroidism WITH positive Thyroid Receptor Antibodies (TRAb) OR on carbimazole during first trimester | |
| 7 | Epilepsy on treatment | |
| 8 | Congenital heart disease | |
| 9 | Connective tissue disease e.g. when on treatment or SLE with Anti-Ro or Anti-La antibodies positive | |
| 10 | Patient on teratogenic agents in 1st trimester | |
| 11 | Maternal Rhesus negative AND indirect agglutination test positive | |
| 12 | Presence of other maternal red cell antibodies | |
| 13 | Drug exposure in pregnancy especially if with known teratogenic risk | |
| Past History | ||
| 14 | Chicken pox especially if contracted in first trimester or early second trimester (< 20 weeks) | Please call early for appointment between 20-24 weeks |
| 15 | History of fetal anomalies | |
| 16 | Previous unexplained stillbirth | |
| Others | ||
| 17 | Patient keen for prenatal diagnosis e.g. First Trimester Screening (FTS), Second Trimester Screening (STS), Non-invasive Prenatal Testing (NIPT) or Karyotyping | As soon as patient indicates her interest for further test |
Klinik Kesihatan & KKIA In Segamat
Consider:
a) Change to another oral iron if unable to tolerate to Zincofer.
Options (to d/w FMS):
1) T Iberet I/I OD/BD (if patient nausea/ vomiting /SE of Zincofer)
2) Maltofer I/I BD/ TDS (if unable to tolerate the metalic taste)
Iron study, FBP, Hb analysis, BFMP, stool ova & cyst
IV Venofer :
1) Treatment for iron deficiency anaemia
2) Poor respond to oral iron ( < 1g/dl in 2/52 or < 2g/dl in 4/52)
3) Unable to tolerate oral iron tablet
IV Cosmofer (additional):
4) Urgency to top up iron (late gestation/before surgery/ delivery)
5) Patient with poor compliance issue/ logistic issue
start prophylaxis T.Obimin I/I OD or T ferrous fumarate I/I OD
To continue with T Zincofer (to d/w FMS)
Repeat FBC every 2 weeks (not Hemocue)
To send Se iron/ TIBC (calculate TSat)
Repeat FBC every 2 weeks (not Hemocue)
Repeat FBC every 2 weeks (not Hemocue)
Contraindications of parenteral iron:
1. First trimester
2. Iron overload
3. Hypersensitivity
**Once Hb > 11 g/dL by FBC, monitor FBC every 2/52 x2, then monthly.
(Cardiac Risk Assessment)
- urgent findings?
(PAC Assessment)
- urgent findings?
¹ Klinik Kesihatan Medical Officer to refer case directly to respective Medical Unit or Anaesthesia PAC Clinic depending on symptoms/signs to avoid delay in referral.
² Klinik Kesihatan Medical Officer must send referral to KP1 through e-mail (klinikpakarobgyn@moh.gov.my).