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

Area of Science:

• Obstetrics and Gynecology
• Fetal Medicine
• Maternal-Fetal Medicine

Background:

• Preterm birth (PTB) remains a significant challenge in perinatal care.
• Effective screening protocols in the third trimester are crucial for managing fetal well-being.
• The Samrakshan program aimed to address PTB through advanced fetal assessment.

Purpose of the Study:

• To evaluate the impact of a third-trimester screening protocol on preterm birth rates.
• To analyze trends in PTB following the implementation of fetal Doppler studies.
• To assess the effectiveness of integrating Doppler studies into routine antenatal care.

Main Methods:

• The Samrakshan program integrated fetal Doppler studies (uterine artery PI, umbilical artery PI, MCA PI, CPR) into third-trimester antenatal scans.
• Clinical stage-based management of fetal growth restriction (FGR) was employed.
• Data were collected from 2019 to 2022, encompassing all third-trimester pregnant women in the program.

Main Results:

• Overall PTB rates declined significantly from 23.18% in 2019-2020 to 10.75% in 2021-2022 (p < 0.001).
• The majority of PTBs occurred between 34 and 37 weeks gestation (16.67%), with fewer (<34 weeks) at 1.66%.
• A consistent year-on-year decrease in PTB rates was observed throughout the study period.

Conclusions:

• The integration of fetal Doppler studies in the third trimester is associated with a significant reduction in preterm birth rates.
• The Samrakshan program's protocol demonstrates the benefit of advanced fetal assessment in improving perinatal outcomes.
• This approach offers a valuable strategy for managing high-risk pregnancies and reducing PTB.