Can Radiologists Guide Pregnancy Care in India?

MedPiper Technologies and JournoMed in Association with IRIA Kerala had conducted a webinar on the occasion of Mother’s Day on 10th May, 2022, where one of the speakers Dr. Rijo Mathew spoke on the topic of “Can Radiologists guide pregnancy care in India for better outcomes?- Saving mothers and babies in India-Samrakshan”

Dr. Mathew was the Secretary of IRIA, Kerala, and is the Founder of IRIA Samrakshan. He is currently the Chairman for Insta Specialty Hospitals, Kochi and Chairman & Chief Radiologist for Amma Centre for Diagnosis and Preventive Medicine Pvt. Ltd, Kochi. He is also a mentor at Amma Healthcare Research Gurukul, Kochi.

Dr. Mathew explained about the major stakeholders involved in pregnancy care and childbirth. He said that the connectivity and the thought process of the different stakeholders such as Obstetrician, Radiologist and Neonatologist is extremely important during pregnancy and childbirth. The role of the Radiologists is especially important as they can help eliminate preterm child births, intrapartum complications, prenatal complications, neonatal deaths etc. As per the statistical data provided, most of them are not aware of these mortality rates that occur with regard to babies i.e. prenatal or perinatal deaths. 

In India every year, nearly 28 million pregnancies occur. Out of which, 26 million live births happen, 67000 maternal deaths occur, 1 million neonatal deaths occur and 7.5 lakh perinatal deaths occur every year. The role of the radiologists is to create an awareness among the women who are pregnant or want to be pregnant regarding the mortality during pregnancy and post pregnancy period.

The various factors that lead to perinatal and neonatal death rate are: 

• congenital abnormalities,
• down’s syndrome
• the prevalence of SGA,
• preeclampsia and eclampsia

Preeclampsia and eclampsia conditions are the most prominent conditions that lead to more fetal growth restrictions.

About Samrakshan

In fetal growth restrictions, there is a failure to achieve required fetal growth which leads to fetal death. For better welfare of pregnant women and to avoid these fetal death rates, Samrakshan, a National Program of the Indian Radiologist and the Imaging Association of India (IRIA) addresses the higher rates of perinatal mortality, low birth weight and preterm babies in India. The aim of this program is to

• integrate fetal monitoring
• improve the performance of the fetal doppler studies during the trimesters of the pregnancy,
• to determine the risk associated with the pre eclampsia and the fetal growth restriction for each pregnant woman.

Samrakshan also developed a program for managing preterm preeclampsia and the fetal growth restriction. 

Samrakshan- 7 star program

Samrakshan designed a 7 star program that focuses mainly on pregnancy care and childbirth. Soon, it will launch e-learning programs designed basically for women’s health and safety during the pregnancy period. Samrakshan has also designed a monthly reporting form for pregnant women. The reporting form will help doctors to access details of various medical case studies so that they can provide an awareness regarding the calamities that occur during the prenatal and perinatal pregnancy care.

Dr. Rijo Mathew explained the core process regarding the pregnancy i.e. the dating and the clinico demographic studies performed during the pregnancy. It is also evident that most of the women in few cases are not aware of their pregnancy and consult the doctor after the intrapartum complications, premature deaths etc. 30% of the mothers can’t remember when their last menstrual cycle was and are not aware that they are pregnant. Due to heavy work force or other unknown circumstances, they have a chance of losing the fetus. 

Measures to avoid eclampsia and FGR conditions 

In India, screening for pre-eclampsia and fetal growth should be made mandatory i.e. during the 11-14 weeks growth of the fetus. This will help in diagnosing pre-eclampsia and eclampsia conditions and thus reduce the fetal growth restrictions.

Conclusion

Fetal doppler integrated antenatal ultrasound studies performed at Samrakshan helps in reducing the prenatal deaths, preterm births and the other pregnancy complications related to the child care. Nearly 20,000 radiologists are involved and working under this project. Preventive radiology is one such branch of radiology which works significantly on reducing prenatal mortality.