PDF herunterladen
CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2019; 29(04): 412-417
DOI: 10.4103/ijri.IJRI_386_19
Fetal Imaging

Samrakshan: An Indian Radiological and Imaging Association program to reduce perinatal mortality in India

Rijo M Choorakuttil
National Coordinator for Samrakshan IRIA, AMMA Center for Diagnosis and Preventive Medicine
,
Hemant Patel
Indian Radiological and Imaging Association, Gujarat Imaging Center, Navrangpura, Ahmedabad, Gujarat
,
Rajalingam Bavaharan
Fetocare Magnum Imaging and Diagnostics, Trichy
,
Palanisamy Devarajan
Nethra Scans and Genetic Clinic, Tiruppur, Tamil Nadu
,
Saneej Kanhirat
Department of Radiology, Starcare Hospital, Kozhikode
,
Ramesh S Shenoy
Consultant Radiologist, Lisie Hospital, Ernakulam, Kerala
,
Om P Tiwari
Consultant Radiologist and Director, Jyothi Hospital, Vijay Nagar
,
Rajendra K Sodani
Consultant Radiologist and Director, Sampurna Sodani Diagnostic Clinic, LG-1, Morya Center, Indore
,
Lalit K Sharma
Raj Sonography and X-Ray Clinic, Baiju Choraha, Nayapura, Guna, Madhya Pradesh, India
,
Praveen K Nirmalan
Chief Research Mentor, AMMA Education Research Foundation, Kochi, Kerala
› Institutsangaben Financial support and sponsorship Nil.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

Context: India has a high perinatal mortality rate. The Indian Radiological and Imaging Association (IRIA) is supplementing efforts to address perinatal mortality in India through the Samrakshan program. Aims: To describe various elements of the Samrakshan program that aims to reduce perinatal mortality in India. Methods: Samrakshan focuses on two priority areas, preeclampsia (PE) and fetal growth restriction (FGR). Samrakshan aims at technical skill upgradation, specifically focused on improved interpretative ability, prognostic and therapeutic efficacy using Doppler studies, a free online learning platform and offline continuous medical educations (CMEs), building an evidence base from the program to develop policy and guidelines, and improving synergy with the RAKSHA program of IRIA and other fetal care stakeholders. Results: Two courses on Doppler studies focused on first trimester and third trimester, supplemented by case discussions and journal articles, have started on the online platform with 230 registrants. The first statewide CME was held at Indore. Samrakshan screening identified 10 (17.24%, 95% CI: 8.59, 29.43) women at high risk for preterm PE and 29 (50.00%, 95% CI 36.58, 63.42) women at high risk for FGR in the first trimester. Ten fetuses (7.63%, 95% CI: 3.72, 13.59) including 9 with stage 1 FGR were identified in the third-trimester screening. Conclusions: Samrakshan is a flagship program of IRIA that aims to reduce perinatal mortality in India through a synergistic, holistic approach that complements and supplements existing efforts in India.

Keywords

Doppler ultrasound - fetal growth restriction - India - perinatal mortality - preeclampsia - screening


Publikationsverlauf

Eingereicht: 18. September 2019

Angenommen: 25. September 2019

Artikel online veröffentlicht:
21. Juli 2021

© 2019. 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/).

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4) 2015-16. India. Mumbai: IIPS; 2017
    Google Scholar
  • 2 Million Death Study Collaborators. Bassani DG, Kumar R, Awasthi S, Morris SK, Paul VK, Shet A. et al. Causes of neonatal and child mortality in India: A nationally representative mortality survey. Lancet 2010; 376: 1853-60
    CrossrefPubMedGoogle Scholar
  • 3 Niti Ayog, India. Maternal Mortality Ratio (per 100,000 live births). Available from: https://www.niti.gov.in/content/maternal-mortality-ratio-mmr-100000-live-births. [Last accessed on 2019 Sep 02]
    Google Scholar
  • 4 Tan MY, Syngelaki A, Poon LC, Rolnik DL, O’Gorman N, Delgado JL. et al. Screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks’ gestation. Ultrasound Obstet Gynecol 2018; 52: 186-95
    CrossrefPubMedGoogle Scholar
  • 5 Rolnik DL, Wright D, Poon LC, O’Gorman N, Syngelaki A, de Paco Matallana C. et al. Aspirin versus placebo in pregnancies at high risk for preterm preeclampsia. N Engl J Med 2017; 377: 613-22
    CrossrefPubMedGoogle Scholar
  • 6 Litwinska M, Syngelaki A, Wright A, Wright D, Nicolaides KH. Management of pregnancies after combined screening for pre-eclampsia at 19-24 weeks’ gestation. Ultrasound Obstet Gynecol 2018; 52: 365-72
    CrossrefPubMedGoogle Scholar
  • 7 Panaitescu A, Ciobanu A, Syngelaki A, Wright A, Wright D, Nicolaides KH. Screening for preeclampsia at 35–37 weeks’ gestation. Ultrasound Obstet Gynecol 2018; 52: 501-6
    CrossrefPubMedGoogle Scholar
  • 8 Figueras F, Gratacós E. Update on the diagnosis and classification of fetal growth restriction and proposal of a stage-based management protocol. Fetal Diagn Ther 2014; 36: 86-98
    CrossrefPubMedGoogle Scholar
  • 9 Malik A, Jee B, Gupta SK. Preeclampsia: Disease biology and burden, its management strategies with reference to India. Pregnancy Hypertens 2019; 15: 23-31
    CrossrefPubMedGoogle Scholar
  • 10 Ghossein-Doha C, van Neer J, Wissink B, Breetveld NM, de Windt LJ, van Dijk AP. et al. Pre-eclampsia: An important risk factor for asymptomatic heart failure. Ultrasound Obstet Gynecol 2017; 49: 143-9
    CrossrefPubMedGoogle Scholar
  • 11 Sharma D, Sharma P, Shastri S. Genetic, metabolic and endocrine aspect of intrauterine growth restriction: An update. J Matern Fetal Neonatal Med 2017; 30: 2263-75
    CrossrefPubMedGoogle Scholar
  • 12 Sharma D, Shastri S, Sharma P. Intrauterine growth restriction: Antenatal and postnatal aspects. Clin Med Insights Pediatr 2016; 10: 67-83
    CrossrefPubMedGoogle Scholar
  • 13 Sharma D, Farahbakhsh N, Shastri S, Sharma P. Intrauterine growth restriction-Part 2. J Matern Fetal Neonatal Med 2016; 29: 4037-48
    CrossrefPubMedGoogle Scholar
  • 14 Sharma D, Shastri S, Farahbakhsh N, Sharma P. Intrauterine growth restriction-Part 1. J Matern Fetal Neonatal Med 2016; 29: 3977-87
    CrossrefPubMedGoogle Scholar
  • 15 Khadilkar AV, Parthasarathy LS. Fetal growth restriction and cardiovascular health among adolescents. Indian Pediatr 2015; 52: 107-8
    CrossrefPubMedGoogle Scholar
  • 16 O’Gorman N, Wright D, Poon LC, Rolnik DL, Syngelaki A, de Alvarado M. et al. Multicenter screening for pre-eclampsia by maternal factors and biomarkers at 11-13 weeks’ gestation: Comparison with NICE guidelines and ACOG recommendations. Ultrasound Obstet Gynecol 2017; 49: 756-60
    CrossrefPubMedGoogle Scholar
  • 17 Sotiriadis A, Hernandez-Andrade E, da Silva Costa F, Ghi T, Glanc P, Khalil A. et al. ISUOG practice guidelines: Role of ultrasound in screening for and follow-up of pre-eclampsia. Ultrasound Obstet Gynecol 2019; 53: 7-22
    CrossrefPubMedGoogle Scholar
  • 18 Tan MY, Wright D, Syngelaki A, Akolekar R, Cicero S, Janga D. et al. Comparison of diagnostic accuracy of early screening for pre-eclampsia by NICE guidelines and a method combining maternal factors and biomarkers: Results of SPREE. Ultrasound Obstet Gynecol 2018; 51: 743-50
    CrossrefPubMedGoogle Scholar
  • 19 Poon LC, Rolnik DL, Tan MY, Delgado JL, Tsokaki T, Akolekar R. et al. ASPRE trial: Incidence of preterm pre-eclampsia in patients fulfilling ACOG and NICE criteria according to risk by FMF algorithm. Ultrasound Obstet Gynecol 2018; 51: 738-42
    CrossrefPubMedGoogle Scholar