Impact of Samrakshan Program in Pregnant Women

Abstract

Introduction: Perinatal mortality remains a major challenge in India. The IRIA-initiated Samrakshan Programme integrates trimester-specific fetal Doppler with antenatal ultrasonography for early detection of pre-eclampsia, FGR, and other high-risk conditions.

Aim & objective: This study evaluated the impact of the Samrakshan Programme on maternal and perinatal outcomes among high-risk pregnancies attending Gajra Raja Medical College (GRMC), Gwalior.

Material & Methods: 36 first-trimester high-risk pregnant women meeting predefined inclusion and exclusion criteria. Participants underwent trimester-specific Doppler evaluation, including uterine artery, umbilical artery, middle cerebral artery, cerebroplacental ratio (CPR) assessments. Women identified as high risk for preterm pre-eclampsia received low-dose aspirin prophylaxis. Maternal and fetal outcomes were analyzed using SPSS version 25, with p<0.05 considered statistically significant.

Results: Normal uterine artery pulsatility index increased significantly from 44.4% in the first trimester to 80.6% in the third trimester (p=0.003), accompanied by a significant reduction in mean arterial pressure (p<0.005). Early aspirin prophylaxis markedly reduced the incidence of pre-eclampsia and prevented FGR among treated high-risk women. Pre-eclampsia was significantly associated with oligohydramnios (p=0.0021), while abnormal third-trimester CPR demonstrated 100% sensitivity, specificity, and diagnostic accuracy for predicting FGR (p<0.001). No maternal deaths and only one stillbirth were recorded, with significantly lower maternal mortality, perinatal mortality, and FGR rates compared with baseline data from Madhya Pradesh (p<0.001).

Conclusion: Samrakshan Programme improved maternal and fetal outcomes through early Doppler risk stratification, aspirin prophylaxis, and serial surveillance. It reduced pre-eclampsia and perinatal mortality, improved uteroplacental perfusion, and enhanced fetal compromise prediction, supporting broader antenatal implementation. Larger multicentric studies are needed to validate findings.

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