Pregnancy and Newborn Health

Basics of Pre-eclampsia and Foetal Growth Restrictions

MedPiper Technologies and JournoMed celebrated World Pre-eclampsia Week Webinar Series in association with National IRIA Preventive Radiology and Samrakshan Committees where various speakers are addressing everything related to Pre-eclampsia and Foetal Growth Restriction during pregnancy. The series of webinars were held from 23rd to 28th May, 2022. 

Role of Samrakshan in India

Dr. Rijo Mathew, Director of IRIA initiated the webinar stating that India has a high perinatal mortality rate. Samrakshan, a National Project initiated by IRIA works for reducing the perinatal mortality via preventive radiology. The radiologists of this program have made considerable progress as major stakeholders in pregnancy, childcare and childbirth in India. 

Samrakshan is a scalar example of how radiology can bring about a change in maternal and foetal mortality.. We are proud that India being a developing nation took an initiative in organising such wonderful activities and guiding pregnant women regarding pre-eclampsia and foetal growth restriction conditions. The program was also successful in promoting the significant role radiologists play in pregnancy and childcare. 

Role of AOSR in Radiology

One of the speakers was Dr. Evelyn Ho Lai Ming. She is the Consultant Clinical Radiologist at Park City Medical Centre, Kuala Lumpur, Malaysia. Dr. Evelyn spoke about World Pre-eclampsia Day and its effectiveness. Pre-eclampsia occurs in about 8% of pregnant women worldwide. In the past, for detecting pre-eclampsia, obstetricians recommended several complex clinical diagnostic procedures. Lately, the non-invasive foetal sonography is the preferred diagnostic method.

Dr. Evelyn Ho Lai Ming, is also a President at the Asian Oceanian Society of Radiology (AOSR). AOSR was founded in Melbourne, Australia (1971). It aims to perform research for the advancement of Radiology and Clinical Radiology. The group also strives for improving radiological procedures and skills to guide the upcoming radiologists regarding technological advancements in Radiology. The main objectives of AOSR are:

  1. National promotion of interdisciplinary research in natural sciences, engineering and application, medical disciplines, etc.
  2. Organising two annual interdisciplinary national conferences. .
  3. Performing Measles and Rubella safety initiative programs -an ongoing project

What do we need to know about Pre-eclampsia and Foetal Growth Restrictions?

Another speaker Dr. Bimal Sahani spoke about pre-eclampsia and foetal growth restrictions. He is the Director of Sonoscan Centre, Aurangabad, National President for Society of Foetal Medicine and worked as an Academic Coordinator at Scholar MD Foetal Medicine Training Program. He said that women with 15% foetal growth restriction may develop pre-eclampsia. Pre-eclampsia with foetal growth restriction is a serious condition. High maternal morbidity is observed in such patients.

Over 10 million women around the world develop pre-eclampsia annually. Out of which, nearly 76,000 pregnant women die every year from pre-eclampsia and other hypertensive disorders. Every 7 minutes time span, one woman loses her life due to these often preventable conditions. Among the South Asian Population, Indian women are the most diagnosed with pre-eclampsia. These numbers brings to mind some major questions:

  1.  how to control such mortality rates, and prevent maternal and neonatal deaths?
  2.  if it is the responsibility of the physicians, neonatologists, obstetricians or radiologists?

All these people are equally responsible and most are not aware of the role Radiologists play. Radiologists being highly qualified professionals play a prominent role in taking care and guiding the pregnant woman during the pregnancy.  Most women in India do not know about pre-eclampsia and foetal growth conditions that they face during the pregnancy. The Samrakshan program aims to bring awareness regarding PE in women which can help to reduce morbidity and mortality to some extent. 

The risk factors in pre-eclampsia include diabetes, obesity etc. The other comorbidities that lead to PE include renal disease, chronic hypertension and hyperglycemia. One must be aware of the 1st trimester screening algorithm advantages, parameters of pre-eclampsia screening, foetal growth restriction and gestational age topics. They should also know about the various biochemical markers which serve as a screening tool for PE. Several softwares can effectively detect the levels of biomarkers and the published algorithms. It is advisable to choose the best screening strategy available for the patients immediately.  

All the specialists, especially radiologists, that are involved in handling pregnant patients, should be educated on topics of  

  1.   early onset and the late onset FGR,
  2.   genetic disorders that lead to early onset FGR such as structural anomalies,
  3.   congenital infections,
  4.   biological markers that are deeply involved in early onset of FGR,
  5.   decision making aspects related to early onset FGR,
  6.   stages of the placental diseases,
  7.   management of FGR in accordance with Doppler
  8.   Barcelona Protocols

Treatment and Need for Understanding Pre-eclampsia

Evidence has shown that an Aspirin a day, can work wonders on preventing the pre-eclampsia condition.

The final speaker was Dr. Praveen Nirmalan, a Research Mentor at AMMA Healthcare Research Gurukul. He briefly touched on the topics of:

  1.       evidence in cured pre-eclampsia conditions with a low dose Aspirin,
  2.       genesis of Samrakshan Program,
  3.       assessing risks involved in pre-eclampsia and FGR,
  4.       analysis of Program based Evidence,
  5.       impact of PE and FGR on perinatal and neonatal mortality rates,
  6.       multidisciplinary team approaches,
  7.       skill enhancement training centres of Samrakshan,
  8.       decentralised community models of Samrakshan

“Saving both mother and a child by screening for pre-eclampsia in the first trimester is mandatory for any pregnant women as per Samrakshan Protocol” says Dr. Nirmalan. He also stated that pregnant women they are more than just statistics and their wellbeing should be of primary importance

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