Fetal Assessment Screening & Tests in Singapore

Fetal Assessment Centre

Are you considering a fetal assessment test during pregnancy? It is a critical step in monitoring your unborn child’s development and well-being. Fetal assessment tests help identify potential health issues early, guiding medical care when it matters most. 

This article outlines which tests are done, their significance, and when they are ordered during pregnancy.

What is fetal screening, and why is it important?

Fetal screening encompasses a range of prenatal tests designed to evaluate your unborn baby’s health. They identify the likelihood of certain congenital disabilities, many of which are genetic disorders. These tests are usually offered during the first or second trimester of pregnancy.

Fetal screening does not provide definitive diagnoses but can assess the risk of genetic disorders and abnormalities. Their importance lies in their ability to:

  • Provide early detection and management of potential health issues
  • Minimise the number of invasive diagnostic procedures for unaffected fetuses
  • Facilitate informed decision-making by expectant parents.

Fetal screening services

Various fetal screening services are available during pregnancy, each serving a unique purpose in ensuring the health and well-being of your baby. The following are some tests a pregnant mother may need according to the trimester of pregnancy.

First-trimester fetal screening and tests

Fetal Doppler test

One of the tests conducted in the first trimester is the Fetal Doppler test. This test employs ultrasound to detect the movement of your baby’s blood vessels, allowing you to hear your baby’s heartbeat for the first time.

OSCAR

The One-stop Clinic for Assessment of Risk (OSCAR) test is conducted between 11 and 13 weeks of gestation and includes a nuchal translucency ultrasound scan and a lab test to measure the thickness at the back of your baby’s neck. The OSCAR test assesses the risk of Down syndrome in the foetus.

Cell-free DNA testing (NIPT)

The Non-Invasive Prenatal Testing (NIPT) can be performed as early as ten weeks into pregnancy. NIPT is a non-invasive blood test that analyses fetal DNA for chromosomal abnormalities.

Maternal blood tests

Maternal blood tests, which include complete blood count (CBC), blood type, Rh factor, and checks for anaemia, are also conducted in the first trimester.

Screening for infectious diseases

Screening for infectious diseases is another crucial aspect of first-trimester testing. Routine screening includes tests for:

  • HIV
  • Hepatitis B
  • Syphilis
  • Immunity to rubella and chickenpox

Detecting and treating these infections early can prevent complications for both the mother and the baby.

Pre-eclampsia screening

Pre-eclampsia screening in the first trimester includes assessing maternal risk factors and biophysical markers like mean arterial pressure and uterine artery pulsatility index. This screening can detect women at risk for developing pre-eclampsia, a serious condition that causes high blood pressure and damage to another organ system, often the liver and kidneys.

Second-trimester fetal screening and tests

Fetal anomaly screening

The fetal anomaly screening, conducted around the 20th week of pregnancy, is a detailed scan of your baby’s body. The scan checks each part of your baby’s body, assessing for any abnormalities that may affect:

  • the brain
  • the face
  • the spine
  • the heart
  • the stomach
  • the bowel
  • the kidneys
  • the limbs

If any abnormalities are detected during the scan, further counselling is offered to discuss the findings.

Ultrasound-guided procedures

Ultrasound-guided procedures enable doctors to diagnose fetal abnormalities through karyotype analysis and molecular studies.

Fetal echocardiography

A fetal echocardiogram, typically performed between the 18th and 24th week of pregnancy, is used to evaluate your baby’s heart for any problems before birth. This test provides detailed images of your baby’s heart structure, blood flow, and rhythm, helping to detect congenital heart disease, heart rhythm disturbances (arrhythmias), and other heart-related issues.

Chorionic villus sampling

Chorionic villus sampling (CVS) is a fetal diagnostic test performed between 10 to 13 weeks of gestation and biopsies of placental tissue for prenatal genetic testing. By offering earlier genetic results, CVS allows for:

  • Early counselling regarding obstetric management
  • Early referral to paediatric subspecialists
  • Safer methods of pregnancy termination if results are abnormal.

Quadruple or triple screen

The Quadruple or Triple Screen test, also known as trimester screening tests conducted in the second trimester, assesses the risk of certain congenital disabilities. This test measures levels of specific substances in the mother’s blood and combines this data with the mother’s age to estimate the baby’s chance of having certain conditions.

Glucose screening test

The Glucose Screening Test is conducted between the 24th and 28th weeks of pregnancy. This test measures blood sugar levels to screen for gestational diabetes. It is a type of diabetes that develops during pregnancy. Diagnosing and managing gestational diabetes is vital as it can lead to health problems in both mother and baby.

Fetal RhD screening

Fetal RhD screening identifies potential blood incompatibilities between the mother and baby, which can cause serious health problems for the baby if not detected and managed.

Amniocentesis

Amniocentesis is usually offered between the 15th and 20th week of pregnancy. It is a fetal diagnostic testing for chromosomal disorders and open neural tube defects such as spina bifida. It involves drawing a small amount of amniotic fluid from the womb for testing.

Third-trimester fetal screening and tests

Doppler blood flow studies

Doppler blood flow studies use ultrasound to measure blood flow through:

  • the umbilical vein and arteries
  • the baby’s brain
  • the baby’s heart
  • other organs

The findings can provide critical information about your baby’s health, particularly in cases where there is a suspicion of intrauterine growth restriction (IUGR).

Group B Streptococcus (GBS) Testing

Group B Streptococcus (GBS) testing is another critical test in the third trimester. GBS is a type of bacteria found in the urinary tract, digestive system, and reproductive tracts. If transmitted to the baby during labour and delivery, it can cause life-threatening infections.

Fetal Non-Stress Test (NST)

The Fetal Non-Stress Test (NST) measures your baby’s heart rate in response to its movements, providing essential insights into your baby’s health as you approach your pregnancy due date.

Biophysical Profile (BPP)

The Biophysical Profile (BPP) evaluates your baby’s well-being. It includes an ultrasound to assess your baby’s movements, breathing, body tone, and the amount of amniotic fluid around your baby.

Amniotic Fluid Index (AFI) measurement

The Amniotic Fluid Index (AFI) measurement is conducted in the third trimester. This test checks the amount of amniotic fluid surrounding your baby. Too much or too little amniotic fluid can indicate potential problems.

Pelvic exams and cervical checks

Pelvic exams and cervical checks are routine procedures conducted in the third trimester. They assess your body’s readiness for labour, providing important information about the baby’s position and the cervix’s dilation and effacement.

Non-Stress Test (NST) for High-Risk Pregnancies

For those with high-risk pregnancies, additional measures are often taken to ensure the health and safety of both mother and baby. One such measure is the fetal Non-Stress Test (NST) for high-risk pregnancies. This test monitors the baby’s heart rate more closely, providing additional reassurance and peace of mind as you approach the birth of your baby.

Access to Fetal Assessment Centre

At SWC Medical Group, we commit ourselves to providing holistic and personalised treatment. That is why, for complex and high-risk obstetric care, we’ll send patients to our Fetal Assessment Centre, which is equipped with additional diagnostic machines. You can be assured that you will have access to the centre as a patient of any specialist with SWC Medical Group.

Why do I need so many tests and scans?

You might be wondering why there are so many necessary tests and scans. Multiple tests increase the accuracy of diagnoses since relying on a single test could lead to false positives or negatives. A series of tests and scans can track changes over time, providing a comprehensive picture of fetal health and allowing for early intervention if necessary.

What is the cost of these tests?

While your baby’s health is priceless, it’s understandable to be curious about the costs of these various fetal screening tests. Their fees can differ according to the specific test, the doctor, and the location.

Are the tests safe?

As an expectant parent, your baby’s safety is your primary concern. You’ll be glad to know that fetal screening tests are generally safe and non-invasive.

Fetal screening & tests in Singapore

Fetal screening and tests provide invaluable insights into your baby’s development and health. While the number and variety of these tests may seem overwhelming, they are all designed with one goal in mind: to give your baby the best possible start in life.

Frequently asked questions

Typically, fetal screening tests are conducted during pregnancy’s first and second trimesters, though some tests also occur in the third trimester. The timing of these tests is designed to correspond with specific stages of fetal development when certain abnormalities or conditions are most detectable.

Fetal screening tests aren’t obligatory. Decisions to undergo them should stem from understanding the risks and benefits of the test results for both parents and the baby.

The time it takes to receive results from fetal screening tests can differ based on the specific test. Most test results are typically available within 1 to 3 days.

Many of these tests may be covered by insurance or subsidised by the government, making them accessible to most expectant parents. You should check with your insurance company to understand the extent of your coverage.

Our Specialists

Our obstetrics and gynaecology specialists have years of experience in providing fetal screening and treatments for women of various ages, backgrounds, and health conditions.  

Dr Ben Choey Wei Yen

Obstetrics & Gynaecology

Dr Chang Tou Choong

Obstetrics & Gynaecology, Maternal Fetal Medicine

Dr Chua Kah Mui Eunice

Obstetrics & Gynaecology, Fertility

Dr Geraldine Tan Pei Lin

Obstetrics & Gynaecology

Dr Koh Cheng Huat

Obstetrics & Gynaecology, Gynae-oncology

Dr Loke Kah Leong

Obstetrics & Gynaecology

Dr Paul Tseng Seng Loke

Obstetrics & Gynaecology, Fertility, Urogynaecology

Dr Phua Soo Mear

Obstetrics & Gynaecology

Dr Serene Lim

Obstetrics & Gynaecology, Fertility 

Dr Shilla Mariah Yussof

Obstetrics & Gynaecology

Dr Tan Guek Cheng Madeleine

Obstetrics & Gynaecology

Dr Tan Wee Khin

Obstetrics & Gynaecology

Why choose
Singapore Women's & Children's
Medical Group?

Full spectrum of Obstetrics & Gynaecology and tertiary Paediatric services

We offer a full suite of Obstetrics & Gynaecology sub-specialties and are able to treat a wide range of paediatric medical conditions.  Apart from the general Obstetrics & Gynaecology, our Obstetrics & Gynaecology specialists have competencies in managing sub-specialties services such as maternal fetal medicine, fertility, gynae-oncology and urogynaecology. Our Paediatric specialists provide medical services in general paediatric and sub-specialise in neonatology, neurology, child development, as well as allergy, immunology and rheumatology.

Team of experienced medical specialists

Both our Obstetrics & Gynaecology and Paediatric medical specialists have proven track records and diverse sub-specialties expertise and these allow us to provide comprehensive, co-ordinated and convenience care through cross referrals and joint management of our patients.

Dedicated management team

Our team is actively involved in the management of our medical clinics, which enables us to respond quickly to the requirements of our patients and to make decisions promptly.