CHiRP - Centre for High Risk Pregnancy

The Department of O&G, SGH is delighted to announce the launch of CHiRP (Centre for High Risk Pregnancies).

The Department of O&G, SGH has a strong reputation for looking after high risk pregnancies, in particular mothers with medical disorders and those with complications. Being sited in a tertiary teaching hospital and an academic medical centre, we have worked hard to develop and establish one-stop joint multi-disciplinary clinics and services between obstetrics and a growing number of medical specialties.

We also work very closely with the departments of Neonatology and Anaesthesialogy, whose facilities and expertise in highly specialised intensive and critical care for preterm babies and  the unwell mothers are crucial to ensure the best possible outcomes in high risk pregnancies. Multidisciplinary forums are organised, often with other medical and surgical disciplines , to discuss management of the more complicated pregnancies. We also enjoy a close collaboration with counsellors and psychiatrists, cognisant  that mental health of the mother  is a very important and often overlooked aspect of holistic care.

 (seated L-R) - Dr Tan Eng Loy, SSN Francine Tu, Assoc Prof Tan Lay Kok, SSN Latifah, Assoc Prof Devendra 

 (standing L-R) - Dr Tan Wei Ching, Dr Yang LiYing

These services are led by the Maternal Fetal Medicine section of the department. With the increasing complexity of cases seen and the growing number of joint clinics, the department of O&G obtained approval to form the Centre for High Risk Pregnancy (CHiRP). The intention is to optimise and streamline the coordination and operation of these services together with the other perinatal services of prenatal diagnosis under one centre. Currently the centre is a virtual one, but we hope to able to have a well sited physical space to house these services under one roof in the near future.

The aim of CHiRP is to provide a one-stop multidisciplinary tertiary integrated care service for high risk pregnancies and optimising pre-pregnancy care and counselling for prospective mothers with risk factors.

​High Risk Clinic	​Patients with bad obstetric history, at risk of preterm labour, placenta praevia, placenta accreta, 2 and more previous caesarean sections, VBAC, hyperemesis gravidarum
​Gestational Diabetic	​Type 1 and 2 Diabetes and gestational diabetes cases
​Cardiology Joint Clinic	​Pre-existing cardiac conditions congenital heart disease, valvular disease, aortopathies, ischaemic heart disease, arrhythmias, cardiomyopathy, heart failure, and new onset cardiac issues
​Rheumatology Obstetric Clinic	​All rheumatological conditions eg SLE, scleroderma, rheumatoid arthritis, vasculitides, mixed connective tissue disease
​Obstetrics & Gynaecology Haematology Clinic	​Complex anaemias eg thalassaemias, Platelet disorders eg ITP (Immune Thrombocytopaenia), Thrombosis , thrombophilias, patients requiring long term anticoagulation

​Obstetric Kidney Clinic	​All pre-existing kidney disorders, renal transplant patients, dialysis patients
​Obstetric Medicine Clinic	​General medical disorders  including hypertension, thyroid disorders, neurological conditions, epilepsy, dermatology , complex multiple medical co-morbidities
​ Fetal Medicine Clinic	​Counselling for prenatal screening and diagnosis (including NIPT & CMA).  Diagnosis and management of fetal anomalies including echocardiography and neurosonography, and intrauterine growth restriction.  Management of monochorionic twins and higher-order multiple pregnancy Rhesus iso-immunisation, fetal infections and intrauterine fetal therapy

CHiRP also looks after the educational and training aspects eg courses, simulation training, as well as research initiatives and projects in high risk pregnancies.