• UGI USER
  • May 22, 2024
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“THE CRUCIAL ROLE OF PERINATAL CARE IN PREVENTING NEUROLOGICAL ANOMALIES “

Syllabus:

  • GS-2- Women issues and efforts by various agencies
  • GS-3- Child care leaves and economy

Focus :

  • The article emphasizes the importance of comprehensive perinatal care in preventing neurological and congenital anomalies in newborns, with a particular focus on managing hypertensive disorders like pre-eclampsia.
  • It highlights the roles of various healthcare stakeholders and the need for early screening, community engagement, and increased awareness to ensure safe motherhood.
Source - TH

Realizing the Miracle of Safe Births

  1. Reflecting on Past Conversations: It has been three decades since a conversation highlighted the miracle of giving birth to a healthy baby. This conversation underscored the importance of perinatal care in safeguarding both mother and newborn.
  2. Addressing Congenital and Neurological Challenges: The prevalence of congenital anomalies and neurological challenges in newborns is higher than often acknowledged. These issues emphasize the need for adequate perinatal care.
  3. Importance of Antenatal and Perinatal Care: Neurological deficits in newborns can often be attributed to insufficient antenatal and perinatal care, highlighting the critical need for improved healthcare practices during pregnancy.
  4. Lifelong Impact: Proper perinatal care has lasting impacts on the health and well-being of both the mother and child, making it a vital area of focus in maternal healthcare.

Collective Responsibility in Perinatal Care

  1. Involvement of Healthcare Stakeholders: The future of our babies and nation depends on the collective efforts of various stakeholders in perinatal care, including obstetricians, radiologists, fetal medicine specialists, neonatologists, and more.
  2. Role of Frontline Workers: Accredited Social Health Activists (ASHAs) and Anganwadi workers play crucial roles in ensuring proper antenatal care, especially in rural and underserved areas.
  3. Importance of Collaboration: Effective perinatal care requires a collaborative approach involving all healthcare providers to ensure the best outcomes for mother and child.
  4. Educational and Training Programs: Continuous education and training for healthcare providers are essential to keep them updated on best practices in perinatal care.

Addressing Hypertensive Disorders in Pregnancy (HDP)

  1. Prevalence and Impact of HDP: Hypertensive disorders of pregnancy, including pre-eclampsia, are significant contributors to maternal and neonatal morbidity and mortality worldwide.
  2. Preventable Conditions: Conditions such as preterm birth, low birth weight, and growth restriction, often resulting from HDP, can be mitigated with proper care.
  3. Long-term Health Implications: HDP can have long-term health consequences for both the mother and child, including increased risk of hypertension, metabolic syndrome, heart disease, and stroke.
  4. Economic Burden: The long-term health complications of HDP add significantly to the economic burden on healthcare systems.

The Importance of Postnatal Cardiovascular Assessment

  1. Neglected Area of Research: Post-partum maternal cardiovascular health, particularly after pre-eclampsia, is a largely neglected area of research.
  2. Increased Risk of Cardiovascular Diseases: Emerging evidence suggests that pre-eclampsia increases the risk of heart failure, coronary heart disease, stroke, and cardiovascular mortality for mothers.
  3. Need for Postnatal Care: A focus on postnatal cardiovascular assessment can significantly improve the long-term health outcomes for mothers who have experienced pre-eclampsia.
  4. Comprehensive Health Monitoring: Continuous monitoring and management of cardiovascular health post-delivery are crucial for the well-being of mothers.
Pre-eclampsia :

Pre-eclampsia is a pregnancy-related hypertensive disorder characterized by high blood pressure and often accompanied by signs of damage to another organ system, most commonly the liver and kidneys. It typically occurs after 20 weeks of gestation and can pose serious risks to both the mother and the fetus if not managed properly.

Current Statistics and the Need for Action in India

  1. Adverse Pregnancy Outcomes: India accounts for nearly a quarter of the world’s adverse pregnancy outcomes, making it a critical area for intervention.
  2. National Family Health Survey (NFHS-5) Statistics: The NFHS-5 highlights perinatal mortality rates of 32 per 1,000 pregnancies and neonatal mortality rates of 25 per 1,000 live births, with hypertensive disorders being a leading cause of maternal death.
  3. Economic and Moral Imperative: Addressing these health concerns is not just a moral imperative but also an economic necessity for the country.
  4. Proactive Measures: Prioritizing proactive measures to ensure safe motherhood and birth is essential, especially in combating conditions like pre-eclampsia.

Understanding and Managing Pre-eclampsia

  1. Symptoms and Diagnosis: Pre-eclampsia, a hypertensive disorder of pregnancy, involves high blood pressure, swelling of the face, hands, and feet, severe headaches, vision changes, upper abdominal pain, and breathing difficulties.
  2. Importance of Early Screening: Implementing screening for pre-eclampsia and fetal growth restriction in the first trimester is crucial for early detection and management.
  3. Comprehensive Screening: Screening should include maternal history, demographics, color Doppler ultrasound, mean arterial pressure, placental biomarkers, and timely pharmacological intervention.
  4. Continued Monitoring: Second and third-trimester screenings are vital for surveillance, early identification of pre-eclampsia, and determining the timing of delivery.

The Role of Color Doppler Ultrasound

  1. Cornerstone of Perinatal Care: Color Doppler ultrasound is essential for optimizing maternal and fetal outcomes throughout all trimesters.
  2. Identifying High-Risk Pregnancies: This technology helps in identifying high-risk pregnancies early, allowing for timely interventions.
  3. Monitoring Fetal Health: Continuous monitoring of fetal health using color Doppler ultrasound ensures better management of potential complications.
  4. Improving Maternal Health: This tool also aids in monitoring maternal health, particularly in cases of hypertensive disorders.

Samrakshan: A Program for Safe Motherhood in India

  1. Mission and Goals: The Indian Radiological and Imaging Association (IRIA) launched the “Samrakshan” program to extend safe motherhood initiatives across India.
  2. Reduction Targets: The program aims to reduce the prevalence of pre-eclampsia from 8%-10% to 3% and fetal growth restriction from 25%-30% to 10% by the end of the decade.
  3. Community Engagement: Community engagement and sustained leadership are crucial for the success of such initiatives.
  4. Championing Safe Motherhood: Samrakshan exemplifies the dedication needed to address and mitigate risks faced by pregnant women and newborns.
Other initiatives for safe motherhood:

1. PMMVY-(Pradhan Mantri Matru Vandana Yojana)-

  • The Ministry of Women and Child Development oversees the implementation of this centrally sponsored program.
  • All pregnant women and lactating mothers (PW&LM) are eligible to receive benefits; however, those who work regularly for the federal, state, or local governments, PSUs, or who receive equivalent benefits under any currently enacted law are not included in this category.

2.  Maternity Benefit (Amendment )Act ,2017-

  • It changed Section 5 of the previous Act to permit paid leave for 26 weeks following childbirth, but only for biological mothers.

Increasing Awareness of Pre-eclampsia

  1. Public Awareness Campaigns: There needs to be greater awareness of pre-eclampsia, a serious hypertensive disorder of pregnancy that is both predictable and preventable.
  2. Educational Initiatives: Educational initiatives targeting healthcare providers and the public can help in early identification and management of pre-eclampsia.
  3. Utilizing Media Platforms: Utilizing various media platforms to disseminate information about the symptoms and risks of pre-eclampsia can improve public knowledge and response.
  4. Encouraging Regular Check-ups: Encouraging regular antenatal check-ups and screenings can lead to early detection and better management of pre-eclampsia and other pregnancy-related complications.

Conclusion

  1. Ensuring Safe Motherhood: Ensuring safe motherhood requires a concerted effort from all stakeholders in the healthcare system, from specialists to frontline workers.
  2. Proactive Measures: Proactive measures, including early screening and comprehensive care, are essential to prevent and manage conditions like pre-eclampsia.
  3. Addressing Long-term Health: Addressing the long-term health impacts of hypertensive disorders in pregnancy is crucial for the well-being of both mothers and children.
  4. Commitment to Health: A strong commitment to maternal and neonatal health can significantly reduce morbidity and mortality rates, paving the way for healthier futures.

Source:The Hindu

Mains Practice Question :

GS-3

“Discuss the significance of comprehensive perinatal care in reducing maternal and neonatal morbidity and mortality, with a focus on the prevention and management of hypertensive disorders such as pre-eclampsia. What role do various healthcare stakeholders and community engagement play in ensuring safe motherhood?” (250 words)