A Guide to Pregnancy: Pre-Conception & First Trimester

The pregnancy journey is an exciting new chapter that starts before conception. Understanding the important milestones from pre-pregnancy through the first trimester helps you look after both your health and your baby’s development.

This article covers what to expect and how to prepare for important milestones in your pregnancy journey. It also provides an overview of Daniel Koh Clinic’s pre-conception and antenatal care.

Pre-Conception

We believe that setting good foundations preconception is important for a good pregnancy outcome. In the months leading up to conception, aim for a healthy lifestyle and balanced diet:

• Eat well: Focus on a balanced diet of vegetables, fruits, whole-grain carbohydrates and lean protein while keeping processed foods and added sugars to a minimum.

• Adopt healthy habits: Stop smoking and drinking alcohol. Remember, there are no safe limits for smoking and alcohol in pregnancy.

• Take the right supplements: Aim for a minimum daily dietary folic acid intake of 400mcg to 800mcg for at least three months before conceiving. Consider an iron supplement if you are vegan or have a dietary restriction.

• Optimise pre-existing medical conditions: Work with your family physician or specialist to bring chronic illnesses like diabetes, hypertension or thyroid disease under control before conceiving.  

• Have regular, spontaneous intercourse: Having sex once every three to four days when not menstruating usually covers the fertile window without the stress of timing and ovulation testing. 

Book a pre-pregnancy consultation with a Fertility Specialist at Daniel Koh Clinic:

• If you are under 35 and have been trying for a baby for over 12 months without success, or  

• If you are over 35 and trying to conceive for over six months without success, or

• If you have irregular periods or

• If you have any fertility-related concerns

When to Schedule A Pre-Pregnancy Check-Up?

The optimal time to see a fertility specialist for a pre-pregnancy assessment is at least three to six months before conception. This allows your fertility specialist and you to have sufficient time to optimise your health and pre-existing medical conditions.

What Is Included in A Pre-Pregnancy Check-Up Package?

A fertility assessment package may cover the following investigations:

• Blood tests:  

  • Full blood count, blood type and rhesus status

  • Infectious disease screen for HIV, Syphilis  

  • Vaccination screen for Hepatitis B and Rubella

  • Hormonal profile including ovulation test

• Urine tests: Screening for asymptomatic urinary tract infections and pre-existing kidney disease

• Cervical smear: To detect any cervical abnormalities or HPV infections

• Thyroid function tests: To detect any thyroid abnormalities. Thyroid hormones play a crucial role in influencing ovulation, menstrual cycles, and the health of the uterine lining

• Imaging tests:

  • Pelvic ultrasound to assess the uterus and ovaries

  • Hysterosalpingogram (HSG) to assess the uterus and patency of fallopian tubes

• Genetic screening: To identify inherited conditions that may affect the offspring

For personalised advice for a pre-pregnancy assessment, please book a pre-pregnancy consultation with a Fertility Specialist at Daniel Koh Clinic.

First Trimester Overview

Most pregnancy specialists (Obstetricians) in Singapore would recommend for patients to book-in for their first pregnancy visit at around six weeks into the pregnancy. At this gestation, doctors are able to clearly detect the presence of a pregnancy sac and also diagnose some early pregnancy complications.

Weeks 6 to 7

Your first pregnancy scan may be an abdominal or a vaginal scan. This would depend on multiple factors including your body size and the size of the pregnancy at this stage.

During the scan, you may see a small, round yolk sac inside the pregnancy sac. A fetal pole may have formed as well. This allows your specialist to determine the gestational age of the pregnancy by measuring its length. A fetal heartbeat may also be visualised using colour Doppler on ultrasound. This is also known as the viability scan.

Once fetal viability is confirmed, your pregnancy specialist may perform blood tests to screen for anaemia, thalassaemia, infectious diseases and blood type and antibodies. This is also known as the antenatal blood tests. 

Your pregnancy specialist may also recommend influenza vaccination for you and your partner at this stage. This is in line with international guideline recommendations from the United Kingdom, the United States and other countries.

Week 8 to 9 

Between the 8th and 9th week of the pregnancy, your fetus is large enough for your pregnancy specialist to take an accurate crown-to-rump length (CRL) measurement. This is known as the dating scan. The CRL measurement allows your pregnancy specialist to calculate the estimated date of delivery (EDD) for the pregnancy

If there is more than one pregnancy, your pregnancy specialist should be able to pick it up confidently at this stage of the pregnancy. 

Weeks 9 to 10

At this stage of your pregnancy, your pregnancy specialist will offer you various options to screen for chromosomal abnormalities in your fetus. This is also known as Down Syndrome Screening or Aneuploidy Screening.

There are two main options:

• OSCAR (One-Stop Clinic for Assessment of Risk for fetal anomalies). It is a first-trimester screening test that combines ultrasound with blood tests to assess the risk of chromosomal abnormalities like Down syndrome (Trisomy 21), Edward's syndrome (Trisomy 18), and Patau syndrome (Trisomy 13). It is performed between 11 and 13 weeks of pregnancy.

• NIPT (Non-Invasive Prenatal Testing). It is a blood test that screens for chromosomal abnormalities like Down syndrome, Edwards syndrome, and Patau syndrome by analysing cell-free fetal DNA (cffDNA) from the placenta which is circulating in the mother's blood. NIPT can be performed from nine weeks of pregnancy.  

Week 11 Onwards

From week 11 onwards, your pregnancy specialist may offer you an early structural screening scan for your fetus.This early structural screening scan is also known as the Nuchal Transluency (NT) scan. The NT scan includes:

• Crown Rump Length

• Fetal Heart Rate

• Nasal Bone

• Nuchal Transluency (the amount of fluid at the back of the baby's neck)

• Major structural screen: Includes evaluation of the fetus’s skull and brain, stomach, abdomen and upper and lower limbs.

• Risk prediction for pre-eclampsia

• Risk prediction for intrauterine growth restriction

Pregnancy Check-Up and Antenatal Care in Singapore

When to See an Obstetrician-Gynaecologist After Conceiving

A consultation with a Singapore gynaecologist is advised after a positive pregnancy test to initiate antenatal care.

What Is Included in the Pregnancy Check-Up Package?

Daniel Koh Clinic’s pregnancy check-up package in Singapore includes:

• Individualised consultations with a maternal fetal medicine specialist

• Ultrasound scans by a maternal fetal medicine specialist

• Foetal growth monitoring

• Blood pressure monitoring and urine testing during each visit

• Quality advice on maternal health and nutrition

Antenatal Check-Up Package: Later Pregnancy Monitoring

From Week 20 onwards, more structured and frequent assessments are conducted to monitor maternal and foetal health. Daniel Koh Clinic offers a comprehensive antenatal check-up package at SGD 1,688 (before GST).

Package Inclusions

• Eight (8) antenatal consultations

• Eight (8) ultrasound scans

Note: Additional charges may apply for extended consultations, specialised scans, or supplementary investigations.

Suggested Antenatal Visit Frequency

• First trimester: Once every 4–6 weeks

• Second trimester: Once every 2–4 weeks

• Third trimester: Once every 1–2 weeks

These suggested intervals are recommended for low-risk pregnancies. If your pregnancy is classified as high-risk, or if there are any complications, your pregnancy specialist may schedule for more frequent reviews to keep a closer watch on you and your fetus. 

Why Choose Daniel Koh Clinic

Specialist Obstetric and Gynaecological Care

Dr Daniel Koh is an obstetrician and gynaecologist with specialised training in fertility medicine and maternal-fetal (high-risk pregnancy) care. He provides personalised treatment plans, accurate ultrasounds and clear and concise advice at every step of your journey to ensure the best health of both mother and fetus.

Accessibility

Patients may reach the clinic via phone, WhatsApp, or email for administrative or clinical enquiries. Prompt assistance is provided throughout the pregnancy.

Book Your First-Trimester Appointment at Daniel Koh Clinic

Whether you are planning to conceive or are already pregnant, Daniel Koh Clinic offers complete pre-pregnancy, pregnancy & antenatal check-up packages in Singapore to support you at every stage.

To schedule a consultation or enquire about our packages, please contact us:

Tel: +65 6025 3345

WhatsApp: +65 8824 3400

Email: enquiry@danielkohclinic.com.sg

Alternatively, fill in the online booking form below to reserve your appointment, and our clinic staff will be in touch with you shortly.

Frequently Asked Questions

What are some common symptoms in early pregnancy?

In early pregnancy, it is common for women to experience some the following symptoms:

• Nausea and vomiting

• Breast tenderness

• Fatigue

• Bloatedness

• Food aversion or craving

• Headaches

• Dizziness

Many of these symptoms are usually harmless and are related to pregnancy related hormonal changes. If your symptoms are affecting your daily activities or if you are experiencing pain or bleeding, you should seek immediate medical advice from your pregnancy specialist.

When do pregnancy symptoms start?

Symptoms such as nausea, breast tenderness, frequent urination and tiredness can appear as early as one week after a missed period (about five weeks pregnant). Most people notice them by week 8.

Is it safe to exercise during pregnancy?

Yes, if you are healthy and your pregnancy is normal, you can keep up or even start light to moderate exercise. Try brisk walking, swimming or prenatal yoga. Talk to your pregnancy specialist  at your first antenatal visit about what activities fit your fitness level.

Is it safe to have sex during pregnancy?

For most pregnancies, having sex is safe. Your pregnancy specialist may advise against sexual intercourse if you have placenta problems, vaginal bleeding or signs of early labour.

Can I travel during pregnancy?

Most women with a singleton pregnancy can travel safely up to 34 to 36 weeks into the pregnancy. Check with your pregnancy specialist if you have any specific concerns.You will need to carry a doctor’s note if you will be travelling by air after 28 weeks of your pregnancy.

Which vaccines are recommended during pregnancy?

• Influenza vaccination is usually given at the start of the pregnancy

• Pertussis vaccine (whooping cough) is usually given between 16 weeks to 32 weeks of the pregnancy

• Respiratory Syncytial Virus vaccine is usually given between 32 and 36 weeks of the pregnancy.