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ceetee

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nckeat, thanks for the inside look at UMMC. I have been going there since I was a baby (my mum gave birth to both me and my bro there) for other related incidents and it's the hospital nearest to my home in PJ. I never had any complaints about the place there - except for the typical long queues but for emergencies (my grandma), it was very quick. It's the hospital I would consider giving birth at if I were to go back to Malaysia. So was curious to know what you think.

ceetee, to echo nckeat, ultrasound is perfectly fine and not to be confused by things like X-ray (that uses radiation which is why if you're pregnant, you should tell your doctor or radiologist). So far, I've gone for one transvaginal (to check if I was miscarrying or pregnant) and three ultrasounds (dating, anomaly and another anomaly). I have another one scheduled for end of April (about 6 weeks after my previous ultrasound).

My uncle's wife lost her first baby just as she was heading into the third trimester and it was because from hypertension (she naturally has high BP) and stress (travelling stresses her out). She went on to get pregnant again twice and now has two healthy children (one boy and one girl).

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meiteoh,

Ops, i think i got you confused over my questions.... i know U/S is safe, well, at least safer than any other scan...

My question is, there isn't regular U/S scan done in goverment clinic for normal check-ups (not as regular as private), is it alright for Dr to omit this? any other way for the Dr to know the feotus' health & condition without doing the scan??

nckeat,

Thx very much for your FOC 'consultation'. :lol: So average U/S scan required is 5 times/pregnancy yah?

Common layman like me, hehehe, will always relate the intrauterine in last trimester death to 'entangled' umbilical cord and suffocation, that's way i just wondered, wouldn't omitting U/S an unsafe procedure???

Btw, are u from Malacca? One of my friend's fiancee is also an O&G from Malacca... :happy:

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meiteoh,

Ops, i think i got you confused over my questions.... i know U/S is safe, well, at least safer than any other scan...

My question is, there isn't regular U/S scan done in goverment clinic for normal check-ups (not as regular as private), is it alright for Dr to omit this? any other way for the Dr to know the feotus' health & condition without doing the scan??

nckeat,

Thx very much for your FOC 'consultation'. :lol: So average U/S scan required is 5 times/pregnancy yah?

Common layman like me, hehehe, will always relate the intrauterine in last trimester death to 'entangled' umbilical cord and suffocation, that's way i just wondered, wouldn't omitting U/S an unsafe procedure???

Btw, are u from Malacca? One of my friend's fiancee is also an O&G from Malacca... :happy:

Gov clinic don't do US regularly because just too many patients. So U/S only done for specific purpose e.g. date, anomaly or growth. Otherwise evrytime during check, they will take your weight, and check the fundal uterine height, ask for baby movement, fetal kick chart etc. These are the indirect way to know your baby health.

Is your friend's fiancee Dr Wan YH. Then, I know her very well. We worked together in GHKL back then.

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ceetee, :lol: - oops, I pagi pagi already blur sotong!!!! Sorry! For me, over here, it's because of cost and "need" factor. Even though the insurance pays for the ultrasounds, only two are compulsory and the rest is up to the doctor. If they feel that you don't need, they won't do an ultrasound (coz it's super ex). But another way of knowing health is that when I go for my antenatal checks, the midwife likes to listen to my baby's heartbeat using a portable doppler to see if the baby is ok or not.

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nckeat,

That's my girl friend, her fiancee is practising in Malacca. :tongue:

meiteoh,

is ok.... preggies are sometimes blur.... i think i'll be blurer when my turn comes... hihihi... :lol:

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hi nckeat,

would like to ask for your opinion, what is your overall comment on tmn desa medical centre?

Most hospitals in private should be ok. The important thing is the hospitals must be well equipped (OT, lab, ambulance, supporting nursing team, other discipline support like surgeon etc). The O&G specialist skill is more or less the same. The deciding factor for outcome especially when serious complication happen is how well the hospital can cope. For example, when massive post parum haemorrhage happen, how fast they can run for the blood? No problem with public hospitals but in private it depend on their emergency ambulance team, their own blood bank, their anasthetist skill.

I quote you a true case that ended as maternal mortality. There was one pregnant lady with history of 2 previous cesarean section and her latest pregnancy was complicated with anterior placenta praevia (low lying placenta at the site of previous scars). This is an extremely super high risk case for an obstetrician becasue the risk is so high that there is a possible cesarean hysterectomy after cesarean section. The risk of massive post partum bleeding is extremely high. This patient was initially admitted to a major public hospital but she preferred to have the op done at a major private hospital in Klang Valley. The outcome, the patient died on operation table due to major blood loss.

The lesson is if you are in major public hospital which the blood bank is just side by side, they can run any amount of blood (my experience when I was in public hospital - 40 pints of blood, some blood was taken as far down from Seremban blood bank) in a relative short time. If you are in private hospital, this is almost impossible. Afterall the ambulance have to beat all the traffice jam in KL to get to national blood bank and fight the jam again back to hospital. This is nothing to do with the O&G specialist skill but the support service especially the blood service.

This is the reason why private specialist tend to choose the low risk cases and send all the high risk cases to public hospitals. Partly because of this, the public hospitals got a higher morbidity and thus the bad name compare to private centre.

Imagine if you deliver at those shoplot practice where there is not a even a lift to send you down when complication happen for transfer to a batter equipped hospital.

In this sense, TDMC should be ok as it is a full service hospital fro low and medium risk cases.

hi nckeat,

thks very much for your explaination! and regarding your other replies, it really clear my mind a lot... really appreciated that!!! :happy:

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Hi nckeat,

It's so good to have you here to share things with us. I have some doubts/concerns after reading some of the comments here, including yours. I hope you would be able to help me to clear those doubts. Thanks in advance!

I'm in pregnancy of 12-weeks now, and I have opt to see Dr. Siti in SJMC based on some references from friends. Dr. Siti is good so far, and nice and friendly but what I'm concernng now after reading the comments here is that she is very popular and busy. Though she has been patient during our visit to her, (2 times so far) but again I'm worried now if she will indeed shorten the time of the trial for the natural delivery. ie: will she be busying at clinic and wants me to go for c-sec? etc...

Have you heard of any of such case from Dr. Siti?

What would you recommend me to do now? Should I change the gynae?

Thanks again!

==================================================

hi nckeat,

would like to ask for your opinion, what is your overall comment on tmn desa medical centre?

Most hospitals in private should be ok. The important thing is the hospitals must be well equipped (OT, lab, ambulance, supporting nursing team, other discipline support like surgeon etc). The O&G specialist skill is more or less the same. The deciding factor for outcome especially when serious complication happen is how well the hospital can cope. For example, when massive post parum haemorrhage happen, how fast they can run for the blood? No problem with public hospitals but in private it depend on their emergency ambulance team, their own blood bank, their anasthetist skill.

I quote you a true case that ended as maternal mortality. There was one pregnant lady with history of 2 previous cesarean section and her latest pregnancy was complicated with anterior placenta praevia (low lying placenta at the site of previous scars). This is an extremely super high risk case for an obstetrician becasue the risk is so high that there is a possible cesarean hysterectomy after cesarean section. The risk of massive post partum bleeding is extremely high. This patient was initially admitted to a major public hospital but she preferred to have the op done at a major private hospital in Klang Valley. The outcome, the patient died on operation table due to major blood loss.

The lesson is if you are in major public hospital which the blood bank is just side by side, they can run any amount of blood (my experience when I was in public hospital - 40 pints of blood, some blood was taken as far down from Seremban blood bank) in a relative short time. If you are in private hospital, this is almost impossible. Afterall the ambulance have to beat all the traffice jam in KL to get to national blood bank and fight the jam again back to hospital. This is nothing to do with the O&G specialist skill but the support service especially the blood service.

This is the reason why private specialist tend to choose the low risk cases and send all the high risk cases to public hospitals. Partly because of this, the public hospitals got a higher morbidity and thus the bad name compare to private centre.

Imagine if you deliver at those shoplot practice where there is not a even a lift to send you down when complication happen for transfer to a batter equipped hospital.

In this sense, TDMC should be ok as it is a full service hospital fro low and medium risk cases.

hi nckeat,

thks very much for your explaination! and regarding your other replies, it really clear my mind a lot... really appreciated that!!! :happy:

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Hi nckeat,

It's so good to have you here to share things with us. I have some doubts/concerns after reading some of the comments here, including yours. I hope you would be able to help me to clear those doubts. Thanks in advance!

I'm in pregnancy of 12-weeks now, and I have opt to see Dr. Siti in SJMC based on some references from friends. Dr. Siti is good so far, and nice and friendly but what I'm concernng now after reading the comments here is that she is very popular and busy. Though she has been patient during our visit to her, (2 times so far) but again I'm worried now if she will indeed shorten the time of the trial for the natural delivery. ie: will she be busying at clinic and wants me to go for c-sec? etc...

Have you heard of any of such case from Dr. Siti?

What would you recommend me to do now? Should I change the gynae?

Thanks again!

Most important is you are comfortable with her and she is willing to spend time with you. Antenatal care for low risk pregnancy is almost the same everywhere. Not all drs do that. That's why it's important to discuss with your doctor about the birth plan on how is she going to manage you intrapartum, how is the monitoring done, what is the pain relief you want, when is the instrument going to be used, at what point she will decide for C section etc . This will alleviate lots of apprehension and fear from the delivering pregnant lady. This will let you anticipate what will happen in the labour rather than ''clueless' about it.

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blue_pierre,

is your gynae Datuk Siti? i heard from my sis that she has stopped delivering babies becoz there was a case with her.... not sure whate case, but some fatality related incident.... correct me if i'm wrong....

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blue_pierre,

is your gynae Datuk Siti? i heard from my sis that she has stopped delivering babies becoz there was a case with her.... not sure whate case, but some fatality related incident.... correct me if i'm wrong....

Thanks Nckeat for your advise. I shall do that when it's a little closer to the date, probably 1 or 2 months prior to the EDD then.

Hi Ceetee,

Yes, my gynae is Dato' Siti in SJMC. Never heard of any case that's happened to her so far. My last visit to her was about 2 weeks back and she seems normal.

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Thanks Nckeat for your valuable info.

I have recently shifted to Klang and may now consider delivering here. Would you know of the facilities at Pantai Klang, Arunamari and Sri Kota Hospital? What about their gynae? Any recommendations?

I am considering these 3 options.

Appreciate a reply. Thanks in advance!

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Thanks Nckeat for your valuable info.

I have recently shifted to Klang and may now consider delivering here. Would you know of the facilities at Pantai Klang, Arunamari and Sri Kota Hospital? What about their gynae? Any recommendations?

I am considering these 3 options.

Appreciate a reply. Thanks in advance!

I never work in Klang before but I have seen those 3 private hospitals. How to decide? Just drive to those 3 facilities and see which one give you most confidence if complication happen and that's the one you should choose. Or you may check in internet. But one of it, I think is involved in a medicolegal case as reported in one of the chinese newspaper but I have not verify it yet but I think it's not difficult to guess which one. Anyway this may not mean they are all bad as complication and arise in any facility (private and public). It is the ability to deal with it is importrant. Which gynae is secondary as long as he can spend time with you to clear your doubt and knows his limitation.

My only advise, avoid shoplot maternity centre.

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Hi all,

I'm TTC now, but the most headache part is I havn't located the hospital around my house which I feel comfortable with, for labour. I've visited a gynae in Assunta Hospital, he was good, but after visiting their Maternity Ward, i got a bit put-off becoz the ward is in the old building, overall looks quite old and dirty. And the nursery looks very dim too.... ( can't seem to keep my baby there... :huh: , mom also discourages...) My mom prefers I go to SJMC or Sunway as both my sisters delivered there too, but that's too far from my house....

Can anyone recommend any hospital within 20-min radius from Bdr Tun Hussein Onn, Cheras, eg. PJ, Kajang, Putrajaya etc.... Pls... :sad:

I recommend u to go Britannia kajang Hospital. Dr.Tan BC is very nice person. When is your EDD?

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Hi all,

I'm TTC now, but the most headache part is I havn't located the hospital around my house which I feel comfortable with, for labour. I've visited a gynae in Assunta Hospital, he was good, but after visiting their Maternity Ward, i got a bit put-off becoz the ward is in the old building, overall looks quite old and dirty. And the nursery looks very dim too.... ( can't seem to keep my baby there... :huh: , mom also discourages...) My mom prefers I go to SJMC or Sunway as both my sisters delivered there too, but that's too far from my house....

Can anyone recommend any hospital within 20-min radius from Bdr Tun Hussein Onn, Cheras, eg. PJ, Kajang, Putrajaya etc.... Pls... :sad:

I recommend u to go Britannia kajang Hospital. Dr.Tan BC is very nice person. When is your EDD?

Hi, yujiki,

I'm TTC only now... no news yet...

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Thanks Nckeat for your valuable info.

I have recently shifted to Klang and may now consider delivering here. Would you know of the facilities at Pantai Klang, Arunamari and Sri Kota Hospital? What about their gynae? Any recommendations?

I am considering these 3 options.

Appreciate a reply. Thanks in advance!

My gynae is Dr.Soh clinic in bukit tinggi, opposite Giant. He do delivery at Sri Kota. Overall, he's good and I have confidence in him. However, during weekend, the queue is long and he may only spend 10-15 minutes with you. But I think compare to 1-2 hrs long wait in SJMC, this one is consider fast already I also found out that during lunch hour, the queue are less. So you can pandai pandai pick your time to visit him.

Services in Sri Kota is not so bad though I can't really compare as I hv not tried other private hospital before. The nurses in labour room was friendly. However, I do feel that their admission procedures is really slow. Sri Kota has maternity packages, you can checkout on their website. For normal delivery, it's RM 1.3k only for 4-bedded ward. However, if there is any complication arise, the bill will be different. My case, I had to use vacuum, so plus some other small small itemized bill, I end up with 2.3-2.5 k.

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nckeat,

Mind telling us how long have you been practising as an O&G and where are you practising?

I have been practicing O&G for past 6 years as specialist or 10 years including my trainee time. I can't reveal where am I practicing for ethical reason.

Hi nckeat,

Can U recommend whether GH or private is better if I m having Placenta Previa?

Thx!

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nckeat,

Mind telling us how long have you been practising as an O&G and where are you practising?

I have been practicing O&G for past 6 years as specialist or 10 years including my trainee time. I can't reveal where am I practicing for ethical reason.

Hi nckeat,

Can U recommend whether GH or private is better if I m having Placenta Previa?

Thx!

If you have placenta praevia especially those major one (type 3 or 4) and with previous C section scar, than you are in a very high risk group.

You have very high risk of bleeding especially during C section so much so your dotor may counsel you regarding possibility of hysterectomy to save your life in case bleeding cannot be stopped.

So your hospital should fullfill these criterias:

1. Have senior obstetrician who can do cesarean hysterectomy.

2. Have good blood bank support and have a system that can deliver any amount of blood within minutes.

3. Good support service like lab, ICU.

4. Have multidisciplinary doctors like surgeon, vascular surgeon and anesthetist (not that type of solo obstetrician practice in shoplot).

5. Good neonatal ICU service.

So for above criterias, I think GHKL, Selayang, Ampang, Putrajaya should be the choice.

For private, depend how confident your obstetrician, imagine when you bleed, the ambulance have to beat the jam from PJ / Subang to National Blood Bank in KL and beat the jam back to private hospital.

In GHKL, the blood bank just across the street and they have bunch of cheap labour (house officer) to run the blood for you FREE 24 hour.

Are you now in hospital. Because if you got PP major, you should be admitted till delivery because bleeding in PP cannot be predicted and if major torrential bleed happen, you need C section immediately. Staying at home may be dangerous because you may not have enough time to reach hospital if major bleed happen.

So my simple answer is public hospital is better if you got PP major. Anyway discuss with your doctor.

How fast you can get the blood is the most important factor.

When I was in one of the state maternal mortality meeting, we came across mnany cases that mother died during C section for placenta praevia because of bleeding and the blood support is very poor especially in private maternity centre.

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nckeat,

Mind telling us how long have you been practising as an O&G and where are you practising?

I have been practicing O&G for past 6 years as specialist or 10 years including my trainee time. I can't reveal where am I practicing for ethical reason.

Hi nckeat,

Can U recommend whether GH or private is better if I m having Placenta Previa?

Thx!

If you have placenta praevia especially those major one (type 3 or 4) and with previous C section scar, than you are in a very high risk group.

You have very high risk of bleeding especially during C section so much so your dotor may counsel you regarding possibility of hysterectomy to save your life in case bleeding cannot be stopped.

So your hospital should fullfill these criterias:

1. Have senior obstetrician who can do cesarean hysterectomy.

2. Have good blood bank support and have a system that can deliver any amount of blood within minutes.

3. Good support service like lab, ICU.

4. Have multidisciplinary doctors like surgeon, vascular surgeon and anesthetist (not that type of solo obstetrician practice in shoplot).

5. Good neonatal ICU service.

So for above criterias, I think GHKL, Selayang, Ampang, Putrajaya should be the choice.

For private, depend how confident your obstetrician, imagine when you bleed, the ambulance have to beat the jam from PJ / Subang to National Blood Bank in KL and beat the jam back to private hospital.

In GHKL, the blood bank just across the street and they have bunch of cheap labour (house officer) to run the blood for you FREE 24 hour.

Are you now in hospital. Because if you got PP major, you should be admitted till delivery because bleeding in PP cannot be predicted and if major torrential bleed happen, you need C section immediately. Staying at home may be dangerous because you may not have enough time to reach hospital if major bleed happen.

So my simple answer is public hospital is better if you got PP major. Anyway discuss with your doctor.

How fast you can get the blood is the most important factor.

When I was in one of the state maternal mortality meeting, we came across mnany cases that mother died during C section for placenta praevia because of bleeding and the blood support is very poor especially in private maternity centre.

Dear nckeat,

10Q so much for ur information..

My EDD is 23/8/2009 and the doc detected PP on my pregnancy since week 20.

Our scan last week shows that the PP is consider as type 1-2.

I do not have any compliations no C-Sect on my last pregnancy... Touch wood there's no bleeding currently but am trying hard to take pre-cautions on that ..

So, apart from those public hospital u recommended, what about Serdang Hospital? Though I have my 1st delivery there, I am not very sure about the facilities or expertise U have mentioned above; ie multidisciplinary doctors like surgeon, vascular surgeon and anesthetist ...

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Dear nckeat,

10Q so much for ur information..

My EDD is 23/8/2009 and the doc detected PP on my pregnancy since week 20.

Our scan last week shows that the PP is consider as type 1-2.

I do not have any compliations no C-Sect on my last pregnancy... Touch wood there's no bleeding currently but am trying hard to take pre-cautions on that ..

So, apart from those public hospital u recommended, what about Serdang Hospital? Though I have my 1st delivery there, I am not very sure about the facilities or expertise U have mentioned above; ie multidisciplinary doctors like surgeon, vascular surgeon and anesthetist ...

You are only 30 weeks plus. Your PP is minor so your doctor will scan you every 2 weeks. So by 34-36th week, your placenta may have already 'move' up and no longer PP.

Serdang is OK. If your PP is minor (type 1 or 2), most major private hospital can handle this.

If your PP is posterior in stead of anterior than the risk is even lower as this kind of case is easier to do as likelihood of going through the placenta during surgery is lower.

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Dear nckeat,

10Q so much for ur information..

My EDD is 23/8/2009 and the doc detected PP on my pregnancy since week 20.

Our scan last week shows that the PP is consider as type 1-2.

I do not have any compliations no C-Sect on my last pregnancy... Touch wood there's no bleeding currently but am trying hard to take pre-cautions on that ..

So, apart from those public hospital u recommended, what about Serdang Hospital? Though I have my 1st delivery there, I am not very sure about the facilities or expertise U have mentioned above; ie multidisciplinary doctors like surgeon, vascular surgeon and anesthetist ...

You are only 30 weeks plus. Your PP is minor so your doctor will scan you every 2 weeks. So by 34-36th week, your placenta may have already 'move' up and no longer PP.

Serdang is OK. If your PP is minor (type 1 or 2), most major private hospital can handle this.

If your PP is posterior in stead of anterior than the risk is even lower as this kind of case is easier to do as likelihood of going through the placenta during surgery is lower.

Thx a lot... :) Have had shread off my headaches on choosing private/ public hospitals now..

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Thanks Nckeat for your valuable info.

I have recently shifted to Klang and may now consider delivering here. Would you know of the facilities at Pantai Klang, Arunamari and Sri Kota Hospital? What about their gynae? Any recommendations?

I am considering these 3 options.

Appreciate a reply. Thanks in advance!

Hello there,

You can try Pantai Klang Specialist Centre, they have a great O&G Dr name Dato Dr Boopalan, famous Dr. Pleasant, sweet and nice Dr. He is partnering with his wife Datin Dr. Noor whom is also a great O&G Dr. Ask around Klang I am sure they know them. He is very famous around Klang.

Hope it helps. ^^

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hi nckeat,

i am just received this good news is almost 6 weeks pregnant..now i pening looking a good place for check up and delivery, since myself was a blood hypertension patient. now feel unconfomtable. now the doctor with me i feel not very safisfied. i am planning to have a gynea doctor until my delivery..

any good sugeestion?

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hi nckeat,

i am just received this good news is almost 6 weeks pregnant..now i pening looking a good place for check up and delivery, since myself was a blood hypertension patient. now feel unconfomtable. now the doctor with me i feel not very safisfied. i am planning to have a gynea doctor until my delivery..

any good sugeestion?

'Good' suggestion will be me! No, just kidding. I can't give suggestion here for ethical reason.

But in my opinion, all obstetricians are well qualified to manage pregnancy. The difference is their communication skill.

The popular one usually have better social and communication skill but the premium you pay is higher (though the things they do is all the same).

So I suggest you ask around your friends and relative or even in this forum, they may give you an opinion.

You as the pregnant mother should also take part in your pregnancy by reading and ask question because doctor sometime don't explain everything and decide some management on you.

I am not sure what you mean by blood hypertension? Do you mean you are hypertensive in term of blood pressure? If yes, it is very very important to start your follow up early because:

1. You need to be rechecked on how high your blood pressure.

2. If BP is high, investigations need to be done to check for any causes.

3. BP monitoring need to be done throughout pregnancy as higher risk of pregnancy induced hypertension or even worse pre-eclampsia (hypertension with protein in urine).

4. High BP may cause placenta insufficiency and growth restriction of baby.

5. Medication may need to be change if your are already on antihypertensive because some antihypertensive is not suitable during pregnancy.

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