Preterm Birth Rates after Initiating the Third-Trimester Screening Protocol of Samrakshan in India: Initial Results

Abstract

Aim To determine the trends in preterm birth (PTB) rates in Samrakshan after initiating a third-trimester screening protocol. Methods The Samrakshan program of IRIA focused on clinical stage-based management of fetal growth restriction (FGR) in the third trimester integrating fetal Doppler studies with routine trimester-specific antenatal scans. Mean uterine artery pulsatility index (PI), umbilical artery PI, middle cerebral artery PI, and cerebroplacental ratio were assessed for all third-trimester pregnant women in the program. Results From 2019 to 2022, 249 (18.33%, 95% CI: 16.34, 20.54) women had PTB with 221 (16.67%, 95% CI: 14.73, 18.75) PTBs between 34 and 37 gestation weeks and 22 (1.66%, 95% CI: 1.10, 2.50) PTBs at gestation < 34 weeks. The overall preterm birth rates showed a significant (chi-square p < 0.001) declining trend each year from 23.18% (n = 121) in 2019–2020 to 16.81% (n = 99) in 2020–2021 and 10.75% (n = 23) in 2021–2022. Conclusions The declining trend of PTB rates in the Samrakshan program shows that the reduction of PTB is an added benefit of the integration of fetal Doppler studies in the third trimester of pregnancy.

Management of women with cervical insufficiency - transformation of views

“…Більше того, рівень передчасних пологів у світі за 2020-2021 рр. зріс на 4% -відповідно з 10,1% до 10,5% [3]. Тобто необхідні подальші зусилля щодо вивчення, виявлення та вдосконалення ведення та нагляду за вагітними для Однією з причин і водночас передвісником настання ПП є істміко-цервікальна недостатність (ІЦН) -структурні зміни в шийці матки, що призводять до неспроможності її затульної функції.…”

Samrakshan Program—An Indian Radiological and Imaging Association Initiative to Reduce Perinatal Mortality in India

“…The trends in various aspects of perinatal health after 2 years of the Samrakshan program were presented by the authors and they found a significant reduction in perinatal mortality, neonatal mortality, PB rates, and rates of PE and FGR compared with national rates as well as compared with the first-year data of Samrakshan taken as baseline. 8 9 …”