Dr Hachem TABBAH - Pregnancy Booklet
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Dr Hachem TABBAH

Welcome to my new Web page!

IN THIS BOOKLET YOU WILL FIND SOME USEFUL INFORMATION CONCERNING YOUR PREGNANCY.
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Pregnancy
Pregnancy Booklet
First please note your
LMP ( Last Menstrual Period ) and
EDD ( Expected Date of Delivery )

ANTENATAL AND POSTNATAL CLASSES ORGANISED AT THE DR ESAM HASHEM SPECIALIST CLINIC :

ANTENATAL CLASSES
TIME : SUNDAYS FORM 12:30 pm TO 2 pm
REGISTRATION : YOU CAN ENROL AS SOON AS YOU HEAR THE GOOD NEWS.
IN ORDER TO INSURE A PLACE IN THE ANTENATAL CLASSES REGISTER BEFORE
24 WEEKS .
COST : 6 WEEKLY CLASSES AT A TOTAL COST OF 600 SR PAYABLE ON BOOKING
CLASSES :
THE AIM OF THESE CLASSES IS TO PREPARE MOTHERS-TO-BE , BOTH PHYSICALLY AND MENTALLY , THROUGH “PSYCHOPROPHYLAXIS” FOR NATURAL CHILDBIRTH , TO GIVE PERSONNAL ADVICE AND TO ANSWER ANY QUESTIONS THAT INDIVIDUALS MAY HAVE.
THE ANTENATAL CLASSES ARE DIVIDED INTO TWO ONE HOUR SESSIONS.
THE FIRST HOUR IS A PRACTICAL SESSION WITH THE PHYSIOTHERAPIST , DURING WHICH , BREETHING AND RELAXATION TECHNIQUES ARE TAUGHT FOR THE DIFFERENT STAGES OF LABOUR , AND POSITIONS AND ADVICE ARE GIVEN FOR DELIVERY . GENTLE EXERCICES ARE TAUGHT TO MAINTAIN THE MUSCLE TONE AND PREVENT THE BACK STRAIN DURING AND AFTER PREGNANCY. HUSBANDS ARE WELLCOME AND ARE SPECIALLY INVITED TO THE LAST CLASS AND ARE ENCOURAGED TO HELP THEIR WIVES DURING LABOUR.
THE SECOND HOUR CONSISTS OF A TALK BY A MIDWIFE , IN WHICH YOU ARE GIVEN VALUABLE ADVICE ON SUCH TOPICS AS : NUTRITION DURING PREGNANCY, DEVELOPPEMENT OF FETUS USING VISUAL AIDS , FEEDING AND STERILISATION OF EQUIPEMENT , THE NEW BORN BABY AND IMMEDIATE POST NATAL PERIOD , GUIDENESS ON BABY CLOTHING , BABY BATHIG , ETC...

INTRODUCTION TO PSYCHOPROPHYLAXIS :
PSYCHOPROPHYLAXIS LITERALLY MEANS “MIND PREVENTION”. THIS INDICATES THAT IT IS CONCERNED WITH MENTAL AWARENESS AND PREPARATION BUT IT IS NOT CONFINED SOLELY TO CHILDBIRTH. IN FACT THE BASIC APPROACH HAS BEEN USED SUCCESSFULLY BY DENTAL PATIENTS AND OTHERS IN WHAT CAN BE CALLED “STRESS SITUATIONS”.
APPLIED TO CHILDBIRTH , THE TEACHING FALLS INTO TWO MAIN CATEGORIES.
FIRSTLY, EDUCATION TO ENSURE THAT THE MENTAL BACKGROUND IS SUITABLE AS A BASIS ON WHICH TO BUILT PHYSICAL PREPARATION.
AND SECONDLY, THE ACTUAL PHYSICAL TRAINING.
THE METHOD ORIGINATED IN RUSSIA AROUND 1949 , AND LATER , A FRENCH OBSTETRICIAN NAMED DR FERNAND LAMAZE LEARNED THE PRINCIPLES FROM HIS RUSSIAN COLLEAGUES AND THEN DEVELOPED THEM FURTER.

BENEFITS OF ANTENATAL CLASSES:
CHILDBIRTH IS AN IMPORTANT AND MEANINGFUL EVENT IN THE LIFE CYCLE OF ANY WOMAN. ANTENATAL CLASSES ASSIST IN THE MENTAL AND PHYSICAL PREPARATION OF A MOTHER - TO - BE , THUS ENABLING AN EASIER BIRTH AND ALLAYING MANY OF THE FEARS THAT CAN DETRACT FROM THE REWARDING EXPERIENCE OF CHILDBIRTH.

POST NATAL EXERCICES
ARE ALSO ORGANIZED. THESE EXERCICES HELP MAITAINING GOOD ABDOMINAL AND PELVIC FLOOR MUSCULAR TONE AND PREVENT LATER PROBLEMS LIKE URINE STRESS INCONTINENCE , BLADDER PROLAPSE , UTERINE PROLAPSE , ETC...

IN CASE OF EMERGENCY
CALL THE CLINIC AT 606 01 00 – 606 16 28
OR 606 14 44 ext 211
CALL HOME OR THE MOBILE NO GIVEN
OR COME TO THE CLINIC

THE FOLLOWING BLOOD TESTS ARE REQUIRED DURING PREGNANCY
· COMPLETE BLOOD COUNT AND HAEMOGLOBIN
· BLOOD GROUP AND RHESUS
· RHESUS ANTIBODIES
· RUBELLA ANTIBODIES
· TOXOPLASMA ANTIBODIES
· HIV TEST ( AIDS TEST )
· HBSAG ANTIBODIES (HEPATITIS B)
· HCV (HEPATITIS C)
· VDRL ( SYPHYLLIS TEST )
· CMV (CYTOMEGALOVIRUS) ANTIBODIES
· TRIPLE TEST : AFP / HCG / ESTRIOL (DETECTS ONLY INCREASED RISK FACTORS FOR NEURAL TUBE DEFECTS AND DOWN’S SYNDROME )

IF YOU HAVE ANY QUERIES REGARDING THESE TESTS FEEL FREE TO DISCUSS THEM WITH ME.
IF YOU HAD THESE TESTS DONE BEFORE PEASE BRING THE RESULTS WITH YOU ,
IF NOT IT IS NECESSARY TO PERFORM THEM.

SPECIAL PROCEDURES
1)AMNIOCENTESIS :
THIS SIMPLE PROCEDURE CAN BE DONE AT THE CLINIC BETWEEN 16 AND 18 POST MENSTRUAL WEEKS OF THE PREGNANCY TO DETECT FETAL CHROMOSOMAL ABNORMALITIES AND MAINLY DOWN’S SYNDROME.
2)INTRAVAGINAL ULTRASOUND SCAN :
THIS PROCEDURE IS HARMLESS AND CAN BEROUTINELY PERFORMED IN EARLY PREGNANCY TO DETECT EARLY ABNORMALITIES.
3)PULSED COLOR DOPPLER ULTRASOUND :
IT IS A SIMPLE PROCEDURE PERFORMED FOR INCREASED RISK PREGNANCIES TO ASSESS FETO-MATERNAL EXCHANGE.
4)TRIPLE TEST :
IT IS A SCREENING TEST FOR DOWN’S SYNDROME AND SPINA BIFIDA .

OBSTETRICAL ULTRASOUND SCAN
THIS IS A HARMLESS PROCEDURE USUALLY PERFORMED DURING PREGNANCY
BETWEEN 16 AND 20 WEEKS
34 AND 38 WEEKS
AND MAY BE MORE IF NEEDED.
YOUR OBSTETRICAL ULTRASOUND CAN BE VIDEORECORDED , PLEASE BRING A VHS VIDEOCASSETTE IF YOU WISH TO HAVE IT DONE.
INDICATIONS FOR AN OBSTERICAL ULTRASOUND
1. CONFIRMATION OF INTRAUTERINE PREGNANCY
2. EXCLUSION OF ECTOPIC PREGNANCY
3. FETAL BIOMETYRY=DETERMINATION OF FETAL GESTATIONAL AGE AND ASSESSMENT OF FETAL GROWTH BY MEASURING THE :
· GESTATIONAL SAC AND ASSESSING ITS VIABILITY
· CROWN RUMP LENGTH ( CRL )
· BIPARIETAL DIAMETER ( BPD )
· HEAD OCCIPUTO-FRONTAL DIAMETER ( OFD )
· HEAD CIRCUMFERENCE ( HC )
· TRANSVERSE ABDOMINAL DIAMETER ( TAD )
· ABDOMINAL ANTEROPOSTERIOR DIAMETER ( APD )
· ABDOMINAL CIRCUMFERENCE ( AC )
· FEMUR LENGTH ( FL )
· HUMERUS , ULNA , RADIUS., TIBIA ,FIBULA LENGTH
· FOOT/FEMUR RATIO
4. LOCALISATION OF PLACENTA AND ASSESSMENT OF PLACENTAL FUNCTION ,GRADE AND MORPHOLOGY.
5. MORPHOSTRUCTURAL ( ANATOMICAL) ULTRASOUND SCAN AND ASSESSMENT OF FETAL WELL-BEING WITH BIOPHYSICAL SCORING :
· VISUALISATION AND ASSESSMENT OF ALL ORGANS
· EARLY DETECTION OF SOME FETAL ABNORMALITIES
· VISUALISATION AND QUALITY ASSESSMENT OF FETAL MOVEMENTS
· EVALUATION OF AMNIOTIC FLUID
· ESTIMATION OF FETAL WEIGHT
· ASSESSMENT OF FETAL HEART RATE IN REAL TIME MOTION DOPPLER
· SEX DETERMINATION
6. HIGH RISK PREGNANCY
7. SPECIAL PROCEDURES:
· AMNIOCENTESIS GUIDED BY ULTRASOUND
· INTRAVAGINAL ULTRASOUND FOR VIABILITY OF EARLY PREGNANCIES
· PULSED COLOR DOPPLER ULTRASOUND FOR HIGH RISK PREGNANCIES

WELL WOMEN CLINIC
A YEARLY CHECK -UP INCLUDES :
· FULL PHYSICAL EXAMINATION
· GYNAECOLOGICAL EXAMINATION
· BREAST EXAMINATION
· ULTRASOUND MAMMOGRAPHY IF NEEDED
· PELVIC ULTRASOUND SCAN IF NEEDED
· PAP SMEAR
· COLPOSCOPY IF NEEDED
· CONTRACEPTION ADVICE

DR HACHEM TABBAH , FRENCH BOARD
CONSULTANT OBSTETRICIAN GYNECOLOGIST
FETAL MEDICINE - ULTRASOUND IMAGING -INFERTILITY

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