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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2022; 32(01): 030-037
DOI: 10.1055/s-0041-1741087
Original Article

Reducing Perinatal Mortality in India: Two-Years Results of the IRIA Fetal Radiology Samrakshan Program

Rijo M. Choorakuttil
1   Department of Radiodiagnosis, AMMA Center for Diagnosis and Preventive Medicine Pvt Ltd, Kochi, Kerala, India
,
Bavaharan Rajalingam
2   Department of Radiodiagnosis, Fetocare Magnum Imaging and Diagnostics, Trichy, Tamil Nadu, India
,
Shilpa R. Satarkar
3   Department of Radiodiagnosis, Antarang Sonography and Colour Doppler Center, Satarkar Hospital, Aurangabad, Maharashtra, India
,
Lalit K. Sharma
4   Department of Radiodiagnosis, Raj Sonography & X-Ray Clinic, Baiju Choraha, Nayapura, Guna, Madhya Pradesh, India
,
Anjali Gupta
5   Department of Radiodiagnosis, Anjali Ultrasound and Colour Doppler Centre, 2nd floor, Shanti Madhuban Plaza, Delhi Gate, Agra, Uttar Pradesh, India
,
Akanksha Baghel
6   Department of Radiodiagnosis, Baghel Sonography Center, Harda, Madhya Pradesh, India
,
Neelam Jain
7   Department of Radiodiagnosis, Jain Ultrasound Centre, Sonari, Jamshedpur, Jharkhand, India
,
Devarajan Palanisamy
8   Department of Radiodiagnosis, Nethra Scans and Genetic Clinic, Tiruppur, Tamil Nadu, India
,
Ramesh Shenoy
9   Department of Radiodiagnosis, Consultant Radiologist, Lisie Hospital, Ernakulam, Kerala, India
,
Karthik Senthilvel 
10   Department of Radiodiagnosis, MS Hospital, Trichy, Tamil Nadu, India
,
Sandhya Dhankar
11   Department of Radiodiagnosis, Faith Diagnostic Center, Chandigarh, India
,
Kavita Aneja 
12   Department of Radiodiagnosis, Images Ultrasound Center, Naveda Healthcare Centre, New Delhi, India
,
Somya Dwivedi
13   Department of Radiodiagnosis, Qura Diagnostics & Research Center, Bhopal, Madhya Pradesh, India
,
Shweta Nagar
14   Department of Radiodiagnosis, Dr. Shweta Nagar's Ultrasound Clinic & Imaging Centre, Indore, Madhya Pradesh, India
,
Sonali Kimmatkar Soni
15   Department of Radiodiagnosis, Navya Diagnostic Center, Near Nissan Motors, Walmiki statue, Gawal mandi, Putlighar, Amritsar, Punjab, India
,
Gulab Chhajer
16   Department of Radiodiagnosis, Kushal Imaging & Diagnostic Center, Sumerpur, Pali, Rajasthan, India
,
Sunitha Pradeep
17   Department of Radiodiagnosis, JIPMER, Puducherry, India
,
Prashant M. Onkar
18   Department of Radiodiagnosis, NKPSIMS, Nagpur, Maharashtra, India
,
Avni K.P. Skandhan 
19   Department of Radiology, Aster MIMS, Kottakkal, Kerala, India
,
Eesha Rajput
20   Department of Radiology, INHS Dhanvantari, Minnie Bay, Port Blair, Andaman & Nicobar Islands, India
,
Renu Sharma
21   Department of Radiodiagnosis, Dr Renu's Diagnostic Center, Sikar, Rajasthan, India
,
Srinivas Shentar
22   Department of Radiodiagnosis, Delta Diagnostic Services, Basavanagudi, Bengaluru, Karnataka, India
,
Suresh Saboo
23   Department of Radiology, JIJU, IIMS Medical College, Jalna, Maharashtra, India
,
Amel Antony
24   Department of Radiology, Lisie Hospital, Kochi, Ernakulam, Kerala, India
,
M.R. Balachandran Nair
25   Department of Radiology, Jubilee Mission Hospital, Thrissur, Kerala, India
,
Tejashree Y. Patekar
26   Department of Radiology, Innovision Sonography and Imaging Center, Gangapur, Nashik, India
,
Bhupendra Ahuja
27   Department of Radiodiagnosis, Dr. Ahuja Ultrasonography and Colour Doppler Center, Delhi Gate, Agra, (Dr. Sarkar Market), Uttar Pradesh, India
,
Hemant Patel
28   Department of Radiodiagnosis, Gujarat Imaging Center, Navrangpura, Ahmedabad, Gujarat, India
,
Mohanan Kunnumal
29   Vice Chancellor, Kerala University of Health Sciences, Thrissur, Kerala, India
,
Rajendra K. Sodani
30   Department of Radiodiagnosis, Sampurna Sodani Diagnostic Clinic, Indore, Madhya Pradesh, India
,
M.V. Kameswar Rao
31   Department of Radiodiagnosis, MKCG Medical College, Berhampur, Odisha, India
,
Pushparaj Bhatele
32   Department of Radiodiagnosis, MRI Centre, NSCB Medical College, Jabalpur, Madhya Pradesh, India
,
Sandeep Kavthale
33   Department of Radiodiagnosis, Indian Radiological and Imaging Association (IRIA), India & Vision Diagnostic Center, Maharashtra, India
,
Deepak Patkar
34   Department of Radiodiagnosis, Nanavati Super Speciality Hospital, Mumbai, Maharashtra, India
,
Rajeev Singh
35   Department of Radiodiagnosis, Radiodiagnosis, Jaipur, Rajasthan, India
,
Amarnath Chelladurai
36   Department of Radiodiagnosis, Stanley Medical College, Chennai, Tamil Nadu, India
,
Praveen K. Nirmalan
37   Department of Research, AMMA Education and Research Foundation, AMMA Healthcare Research Gurukul, Kochi, Kerala, India
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Abstract

Aim The aim of the study is to determine improvements in perinatal mortality at the end of the first 2 years from the initiation of the Samrakshan program of the Indian Radiological and Imaging Association.

Methods Samrakshan is a screening program of pregnant women that uses trimester-specific risk assessment protocols including maternal demographics, mean arterial pressure, and fetal Doppler studies to classify women as high risk or low risk for preterm preeclampsia (PE) and fetal growth restriction (FGR). Low dose aspirin 150 mg daily once at bedtime was started for pregnant women identified as high risk in the 11–136/7 weeks screening. The third-trimester screening focused on the staging of FGR and protocol-based management for childbirth and risk assessment for PE. Outcomes of childbirth including gestational age at delivery, development of PE, and perinatal mortality outcomes were collected.

Results Radiologists from 38 districts of 16 states of India participated in the Samrakshan program that screened 2,816 first trimester, 3,267 second trimester, and 3,272 third trimester pregnant women, respectively. At 2 years, preterm PE was identified in 2.76%, preterm births in 19.28%, abnormal Doppler study in 25.76% of third trimester pregnancies, and 75.32% of stage 1 FGR delivered at term. The neonatal mortality rate was 9.86/1,000 live births, perinatal mortality rate was 18.97/1,000 childbirths, and maternal mortality was 58/100,000 live births compared with 29.5, 36, and 113, respectively in 2016.

Conclusion Fetal Doppler integrated antenatal ultrasound studies in Samrakshan led to a significant reduction in preterm PE rates, preterm birth rates, and a significant improvement in mean birth weights. Perinatal, neonatal, and maternal mortality rates are significantly better than the targets for 2030 set by the Sustainable Development Goals-3.

Keywords

preeclampsia - fetal growth restriction - fetal Doppler - perinatal mortality - neonatal mortality

Work Attributed to

Indian Radiological & Imaging Association, IRIA House, C-5, Qutab Institutional Area, New Delhi 110016, India,


Financial Disclosures

None of the authors have any financial interests to disclose with respect to this study and manuscript.




Publication History

Article published online:
19 April 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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