Preeclampsia Awareness Month: A Crucial Call for Maternal Health in India

Preeclampsia, a potentially life-threatening hypertensive disorder of pregnancy, affects millions of women worldwide, and India bears a significant burden of this condition. While May is recognized globally as Preeclampsia Awareness Month, with World Preeclampsia Day specifically observed on May 22nd, continuous efforts are crucial to educate, identify, and manage this silent threat to maternal and infant health, particularly in a diverse and populous country like India.

 

 

India faces problems not only in being unaware but despite doctor’s input many patients skip mentioning even the smallest symptoms due to the socio-cultural attitude that these are normal things for women to bear silently.

 

 

 

 

Preeclampsia is characterized by high blood pressure and signs of organ damage, most commonly affecting the kidneys, liver, brain, and blood system. It typically develops after 20 weeks of pregnancy or even in the postpartum period. If left undiagnosed or untreated, it can progress to eclampsia, leading to seizures, stroke, multiple organ failure, and even death for both mother and baby.

 

 

In India, the prevalence of preeclampsia can vary, with estimates ranging from 0.3% to a concerning 25.8% of pregnancies in different regions. Hypertensive disorders of pregnancy, including preeclampsia, are a leading cause of maternal and infant mortality and morbidity. This underscores the urgent need for heightened awareness and effective interventions.

 

 

“As a radiologist, I help monitor high-risk pregnancies like preeclampsia using ultrasound and Doppler scans. These tests show if the baby is growing well and getting enough blood. Early detection through imaging can save lives — both the mother’s and the baby’s. This also helps the gynaecologist or treating doctor to decide if early delivery is needed to keep mother and baby safe. Blood pressure monitoring is crucial to pick on the symptoms. Generally patients wont show up for regular visits ; they come only when something is wrong like bleeding. This is especially seen in rural areas; because they dismiss small symptoms like swelling in feet or dizziness or sometimes even blurring of vision as something that’s normal in pregnancy.  So regular checkups is key for detection”; says Dr Sunanda Samanta, a radiologist at Choithram Hospital

 

 

She further informs that - 

 

 

As per the Government of India and WHO guidelines, the minimum number of mandatory antenatal checkups are:

 

Government of India (Pradhan Mantri Surakshit Matritva Abhiyan - PMSMA):

 

At least 4 antenatal visits are recommended:

 

1. First visit: Around 12 weeks

2. Second visit: Between 14–26 weeks

3. Third visit: Between 28–34 weeks

4. Fourth visit: After 36 weeks

 

However, this is a minimum and more visits are encouraged, especially for high-risk pregnancies. 

 

 

 

 

High blood pressure (above 140/90 mmHg)

Protein in the urine (proteinuria)

Severe headaches

Blurred vision or sensitivity to light

Sudden swelling in the face, hands, or feet

Upper abdominal pain (usually on the right side)

Nausea or vomiting

Shortness of breath

Sudden weight gain

 

 

 

 

First-time pregnancy

History of preeclampsia in a previous pregnancy

Family history of preeclampsia

Being under 20 or over 40 years old

Carrying multiple babies (twins, triplets)

Pre-existing conditions like chronic hypertension, diabetes, kidney disease, or obesity

 

 

 

 

Despite its severity, awareness about preeclampsia remains low, particularly in rural and underserved areas of India. Many pregnant women and their families may not recognize the symptoms, leading to delayed diagnosis and management. This knowledge gap contributes significantly to adverse outcomes.

 

Preeclampsia Awareness Month serves as a vital reminder to:

 

 

1.   Educate pregnant women and their families: Empowering women with knowledge about symptoms and risk factors enables them to seek timely medical attention.

 

2.   Train healthcare providers: Ensuring that doctors, nurses, ASHA workers, and other frontline health workers are well-equipped to identify, screen, and manage preeclampsia is paramount.

 

3.   Promote early detection and intervention: Regular prenatal check-ups, including blood pressure monitoring and urine tests, are crucial for early diagnosis.

 

4.   Advocate for policy changes: Supporting government initiatives and quality improvement projects can lead to better care practices and reduced maternal mortality rates.

 

 

 

Several organizations and government initiatives are working towards raising awareness and improving outcomes for women affected by preeclampsia in India:

 

 

1.   Pradhan Mantri Surakshit Matritva Abhiyan (PMSMA): Launched by the Ministry of Health & Family Welfare, Government of India, PMSMA aims to provide assured, comprehensive, and quality antenatal care free of cost to all pregnant women on the 9th of every month. This program specifically focuses on identifying and following up with high-risk pregnancies, including those susceptible to preeclampsia, and involves the support of private sector doctors.

https://www.pib.gov.in/PressNoteDetails.aspx?NoteId=154004&ModuleId=3 

 

 

2.   UNICEF India: UNICEF works closely with the Ministry of Health and Family Welfare (MoHFW) and other government bodies to strengthen maternal health services. Their efforts include improving access to antenatal care, promoting skilled birth attendance, and focusing on high-risk pregnant women in vulnerable communities. Preeclampsia is recognized as one of the major complications contributing to maternal deaths that UNICEF's initiatives aim to address. https://www.unicef.org/india/what-we-do/maternal-health 

 

 

3.   The Federation of Obstetric and Gynaecological Societies of India (FOGSI): FOGSI, a professional body of obstetricians and gynecologists in India, plays a significant role in raising awareness and improving clinical practices related to preeclampsia. They actively collaborate with government programs like PMSMA and work to motivate their members to provide free antenatal care services.

 

 

4.   Intignus Biotech: This enterprise, supported by Villgro, is developing innovative solutions for early detection of preeclampsia, such as their PEscreen® test. They undertake awareness-building activities, including skits and interactions with healthcare professionals and pregnant women in hospitals, to educate the public on early detection and management. Their efforts highlight the clear lack of awareness and the positive impact of such initiatives. https://intignusbiotech.com/preeclampsia-screening-test/#:~:text=PEscreen%C2%AE%20%2D%20Preeclampsia%20Screening%20Test,risk%20of%20development%20of%20preeclampsia 

 

 

5.   The George Institute for Global Health: This organization conducts awareness campaigns, often in collaboration with local health bodies, to strengthen antenatal and postnatal care. Their "SMARThealth pregnancy project" in Haryana, for instance, involved educating mothers and ASHA workers about high-risk pregnancies, including those related to high blood pressure, and encouraging them to seek timely care using electronic tablets for monitoring and referral.

 

 

6.   Various Hospitals and Healthcare Networks: Numerous hospitals across India, like TX Hospitals and PACE Hospitals, actively participate in Preeclampsia Awareness Month and World Preeclampsia Day by publishing informative articles, conducting awareness drives, and offering specialized antenatal care. They emphasize routine prenatal visits, early screening, and healthy lifestyle choices.

 

 

 

 

While global efforts highlight preeclampsia in May, the need for sustained awareness and action in India is year-round. By strengthening collaborations between government bodies, non-profit organizations, healthcare providers, and communities, India can make significant strides in reducing the burden of preeclampsia and ensuring healthier outcomes for mothers and their newborns. Emphasizing early detection, consistent prenatal care, and readily accessible information will be critical in transforming the landscape of maternal health in the country.