Samrakshan (IRIA): Protecting India's Future Generations

Project Samrakshan

The Crisis The Solution The Method The Impact The Future

Protecting India's Future Generations

An analysis of the Indian Radiological & Imaging Association's landmark program to drastically reduce perinatal mortality through predictive radiology.

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% Reduction in Perinatal Mortality

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% Reduction in Neonatal Mortality

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% Reduction in Maternal Mortality

The Perinatal Mortality Crisis

India faces a significant public health challenge with one of the world's highest burdens of perinatal mortality. This section explores the scale of the problem and the vast regional disparities that necessitate a nationwide, standardized intervention like Project Samrakshan.

36 / 1,000

National Perinatal Mortality Rate (NFHS-4)

18.2%

Incidence of Low Birth Weight Babies

~10%

Pregnant women affected by Preeclampsia

A Tale of Two States: The Stark Disparity

The national average hides extreme variations in healthcare outcomes across states, highlighting the need for equitable access to quality diagnostics.

Uttar Pradesh

56

Perinatal deaths per 1,000 pregnancies

Kerala

8

Perinatal deaths per 1,000 pregnancies

The Solution: A Proactive, Three-Pillar Strategy

Project Samrakshan moves radiologists from a reactive diagnostic role to a proactive one in antenatal care. Its design is built on three core pillars aimed at transforming routine scans into a powerful predictive and preventative tool, fundamentally changing the approach to maternal healthcare in India.

1

Integrate Fetal Doppler

Systematically incorporate advanced Doppler studies into routine antenatal scans to assess placental function.

2

Customize Risk Assessment

Use multiparametric data to calculate a personalized risk score for preeclampsia and FGR for each pregnancy.

3

Protocol-Based Management

Ensure high-risk pregnancies receive standardized, evidence-based care in synergy with obstetricians.

The Scientific Method

The program's success is rooted in a scientifically rigorous, trimester-specific screening protocol. Click through the tabs below to explore how the focus shifts from early prediction and prevention to late-stage surveillance and management, all powered by the technology of Fetal Doppler.

Prediction & Prevention (11-14 Weeks)

1. Multiparametric Screening

   Combines maternal history, mean arterial pressure (MAP), and Uterine Artery Doppler (PI) to gather comprehensive data.

2. Algorithm-based Risk Calculation

   Data is fed into competing risk models to generate a precise, individualized risk score for developing preterm preeclampsia.

3. Prophylactic Intervention

   High-risk women are recommended low-dose aspirin before 16 weeks, a proven therapy to reduce the incidence of the disease.

Surveillance & Management

The goal shifts to identifying fetuses under distress and guiding delivery timing. The key is to distinguish a pathologically growth-restricted fetus (FGR) from one that is just constitutionally small (SGA).

Fetal Growth Restriction (FGR)

Pathological condition from placental insufficiency. Requires intensive monitoring and timely, often preterm, delivery to prevent adverse outcomes.

Small for Gestational Age (SGA)

A healthy but constitutionally small fetus. Can often be safely carried to term, avoiding unnecessary interventions and iatrogenic prematurity.

The Core Technology: Fetal Doppler

Doppler ultrasound provides functional information about blood flow, revealing fetal distress long before other methods. Click on a parameter to learn more.

Uterine Artery (UtA) PI

Measures resistance in uterine arteries. High resistance indicates poor placentation.

Umbilical Artery (UA) PI

Measures resistance in the placenta itself. High resistance points to placental disease.

Middle Cerebral Artery (MCA) PI

Measures blood flow in the fetal brain. Low resistance indicates "brain-sparing" due to hypoxia.

Cerebroplacental Ratio (CPR)

Ratio of MCA to UA. A low CPR is a very sensitive, early marker of fetal compromise.

A Story of Impact

The results from the first two years of Project Samrakshan are not just encouraging, they are transformative. This interactive chart compares the program's outcomes against the national baseline, demonstrating a profound reduction in maternal and child mortality and proving the efficacy of this innovative approach.

The Horizon: Scaling the Success

Building on its proven success, Project Samrakshan is evolving with an ambitious dual strategy: scaling up domestically to ensure universal access within India, and expanding internationally to become a model for the developing world.

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Samrakshan 757

The national scale-up initiative aiming to establish a trained "Samrakshan Yodha" (radiologist champion) in every one of India's districts. The goal is to make these life-saving protocols universally accessible and reduce preeclampsia incidence to <3% nationwide.

🌍

GSASM

The Global South Alliance for Safe Motherhood is the international extension of the project. It aims to share the Samrakshan model as a frugal, effective innovation for other low- and middle-income countries facing similar public health challenges.

Interactive report created based on the analysis of Project Samrakshan by the IRIA.

This is a conceptual visualization and not an official publication of the IRIA.