Why in the News?

The prevalence of Congenital Anomalies and Neurological Challenges in newborns highlights the need for adequate Antenatal and Perinatal care to address them.

Key observations made by the National Family Health Survey (NFHS-5):

Perinatal mortality rates stand at 32 for 1,000 pregnancies, neonatal mortality rates at 25 for 1,000 live births, and hypertensive disorders in pregnancy remain a leading cause of maternal death.

• Cause of Maternal and Perinatal Mortality: Preeclampsia (PE) is a significant cause of maternal and perinatal morbidity and mortality, with early onset PE posing higher risks.  
• Combination of Maternal factors and Biomarkers: Screening based on maternal risk factors alone has suboptimal performance, while a combination of maternal factors and biomarkers like mean arterial pressure, uterine artery pulsatility index, and serum placental growth factor can improve detection rates significantly.
• Early Intervention with Aspirin Prophylaxis: First-trimester screening models, like the FMF prediction algorithm, have been effective in identifying high-risk pregnancies for preterm PE, allowing for early intervention with aspirin prophylaxis to reduce the incidence of preeclampsia.

Challenges to cure Pre-eclampsia (PE):

• Complex Screening Protocols: Effective screening requires a combination of maternal history, demographics, color Doppler ultrasound, mean arterial pressure, and placental biomarkers, which may not be uniformly available or implemented.
• Limited Resources: Not all healthcare facilities have access to advanced screening tools and technologies like color Doppler ultrasound and placental biomarker testing.
• Lack of Awareness: Pregnant women may not be aware of the symptoms and risks associated with pre-eclampsia, leading to delayed presentation and diagnosis.
• Delayed Intervention: Identifying high-risk pregnancies early is crucial, but delays in screening and diagnosis can lead to missed opportunities for timely intervention.
• Pharmacological Challenges: Ensuring timely pharmacological intervention, such as aspirin prophylaxis, requires adherence to established protocols, which may only sometimes be followed.
• Logistical Issues: Implementing widespread screening and management protocols involves logistical challenges, including training healthcare providers and ensuring the availability of necessary equipment.
• Complexity of the Disorder: The systemic nature of pre-eclampsia, affecting multiple organs, complicates its management and requires a multidisciplinary approach.

Programs in India:

• “Samrakshan” program: The Indian Radiological and Imaging Association’s (IRIA) “Samrakshan” program aims to reduce pre-eclampsia from 8%-10% to 3% and fetal growth restriction from 25%-30% to 10% by the end of the decade.
• The program focuses on spreading awareness, screening for pre-eclampsia and fetal growth restriction, and ensuring comprehensive care throughout pregnancy.

Way Forward: 

• Early Detection and Management: Early detection through regular prenatal care, including blood pressure monitoring and urine testing for protein, is crucial in managing pre-eclampsia.

• • Timely intervention can help prevent severe complications and ensure the well-being of both mother and baby.
• Promoting Awareness and Education: Raising awareness about the signs and symptoms of pre-eclampsia among pregnant women is essential for early recognition and prompt action.
  • Education on risk factors, preventive measures, and the importance of regular antenatal check-ups can significantly impact maternal and neonatal outcomes.
• Ensuring Access to Quality Maternal Healthcare: Access to quality maternal healthcare services, including skilled antenatal care, monitoring, and timely interventions, is vital in addressing pre-eclampsia and reducing maternal mortality rates.
  • Empowering healthcare providers with the knowledge and resources to manage pre-eclampsia effectively is key to ensuring safe motherhood.
• Collaborative Efforts for Maternal Health: Collaboration between governments, healthcare institutions, non-profit organisations, and the private sector is essential in implementing comprehensive maternal health programs that prioritise the prevention, early detection, and management of pre-eclampsia.

Conclusion: By spotlighting pre-eclampsia and emphasising the importance of early detection, awareness, access to quality care, and collaborative efforts, we can strive towards ensuring safe motherhood for all women, safeguarding the health and well-being of mothers and their babies.

Mains PYQ:

Q Identify the Millennium Development Goals (MDGs) that are related to health.Discuss the success of the actions taken by the Government for achieving the same.(UPSC IAS/2013)

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