INTRODUCTIONThe study aimed to assess the level of awareness and knowledge of contraception among women in Singapore, and identify the factors that influence contraception choice.

METHODSWe conducted a cross-sectional survey of 259 female patients, aged 21-49 years, who attended the Obstetrics and Gynaecology Clinic at National University Hospital, Singapore. An original questionnaire on nine contraceptive methods was used. Respondents who had ≥ 2 correct answers for a method (out of four questions) were considered to have good knowledge of the method. Participants were asked to rate factors known to influence contraceptive choice as important or not important.

RESULTSAwareness of the following methods was high: condom (100.0%), oral contraception pill (89.2%), tubal ligation (73.0%) and copper intrauterine device (IUD) (72.2%). The women were least aware of hormonal IUD (24.3%). Women who were parous, had a previous abortion, had completed their family or used contraception previously were more likely to have a higher awareness of contraception. 89.2% of the women had good knowledge of the condom; among those aware of hormonal IUD, only 46.0% had good knowledge of it. Women who had used hormonal IUD and the condom were more likely to have good knowledge of them. Many rated efficacy (90.5%) and a healthcare professional's advice (90.1%) as important in contraceptive choice. Few considered peer influence (21.0%) and cultural practices (16.3%) to be important.

CONCLUSIONWomen in Singapore have poor awareness and knowledge of contraception, especially long-acting reversible methods. More effective ways are needed to educate women about contraceptive methods.

Abortion, Induced ; Adult ; Choice Behavior ; Condoms ; Contraception ; methods ; Contraceptives, Oral ; Cross-Sectional Studies ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Intrauterine Devices ; Middle Aged ; Parity ; Patient Education as Topic ; Singapore ; Social Class ; Sterilization, Tubal ; Surveys and Questionnaires ; Young Adult

Pregnancy ; Female ; Humans ; Mosaicism ; Prenatal Diagnosis ; Prenatal Care ; Aneuploidy

The options for prenatal genetic testing have evolved rapidly in the past decade, and advances in sequencing technology now allow genetic diagnoses to be made down to the single-base-pair level, even before the birth of the child. This offers women the opportunity to obtain information regarding the foetus, thereby empowering them to make informed decisions about their pregnancy. As genetic testing becomes increasingly available to women, clinician knowledge and awareness of the options available to women is of great importance. Additionally, comprehensive pretest and posttest genetic counselling about the advantages, pitfalls and limitations of genetic testing should be provided to all women. This review article aims to cover the range of genetic tests currently available in prenatal screening and diagnosis, their current applications and limitations in clinical practice as well as what the future holds for prenatal genetics.
Child ; Pregnancy ; Female ; Humans ; Prenatal Diagnosis ; Knowledge ; Parturition

Pregnancy ; Female ; Humans ; Influenza, Human/prevention & control* ; Cross-Sectional Studies ; Whooping Cough/prevention & control* ; Vaccination ; Influenza Vaccines/therapeutic use* ; Health Knowledge, Attitudes, Practice ; Surveys and Questionnaires ; Pregnancy Complications, Infectious/prevention & control* ; Patient Acceptance of Health Care

INTRODUCTIONManagement of complicated monochorionic twins and certain intrauterine structural anomalies is a pressing challenge in communities that still lack advanced fetal therapy. We describe our efforts to rapidly initiate selective feticide using radiofrequency ablation (RFA) and selective fetoscopic laser photocoagulation (SFLP) for twin-to-twin transfusion syndrome (TTTS), and present the latter as a potential model for aspiring fetal therapy units.

METHODSFive pregnancies with fetal complications were identified for RFA. Three pregnancies with Stage II TTTS were selected for SFLP. While RFA techniques utilising ultrasonography skills were quickly mastered, SFLP required stepwise technical learning with an overseas-based proctor, who provided real-time hands-off supervision.

RESULTSAll co-twins were live-born following selective feticide; one singleton pregnancy was lost. Fetoscopy techniques were learned in a stepwise manner and procedures were performed by a novice team of surgeons under proctorship. Dichorionisation was completed in only one patient. Five of six twins were live-born near term. One pregnancy developed twin anaemia-polycythaemia sequence, while another was complicated by co-twin demise.

DISCUSSIONProctor-supervised directed learning facilitated the rapid provision of basic fetal therapy services by our unit. While traditional apprenticeship is important for building individual expertise, this system is complementary and may benefit other small units committed to providing these services.