Early identification of high-risk pregnancies in rural areas of Karnataka through maternal obstetric monitoring program

Srujan G. Janagam, Smitha T. Kaniyampady, Anupama N. Shetty


Maternal mortality rate (MMR) has been one of India’s key priority areas. Over the years. several national programs have addressed issues of accessibility and affordability of antenatal care. Major gaps in the system include shortage of trained human resource and technological infrastructure in providing essential diagnostic ante-natal care. High risk pregnancies (HRP) owing to various factors, account for 70-80% of maternal deaths. This case study describes the clinical and workflow process innovation in ante-natal care in Shorapur taluka, a rural region of Northern Karnataka. Maternal obstetric monitoring (MOM) through a defined protocol for high-risk pregnancy identification aided by ultrasound scans, was introduced at the sub-district hospital. In parallel, system strengthening was done through capacity building activities, installation of blood storage unit and provision of ultrasound services. The model demonstrates that process and technological innovations can be leveraged on to facilitate and make available specialist medical services in rural areas, which is key to identification and timely management of high-risk pregnancies.


High risk pregnancies, Technology, Ultrasonography, Maternal mortality rate

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Sharma D. India still struggles with rural doctor shortages. The Lancet. 2015;386:10011:P2381-82.

Pradeep MK, Gnanadeep NV, Umesh RD, Pushpa SP. Prevalence Of High Risk Pregnancy In Rural Dharwad. J Dent Med Sci. 2015;10:29-32.

GO, Elizabeth UN, Peter NE. Assessment of the risk status of pregnant women presenting for antenatal care in a rural health facility in Ebonyi State, South Eastern Nigeria. N Am J Med Sci. 2011;3(9):424-7.

Himanshu M, Kumar A, Chandrashekarappa B, Kumar P, Suresh M, Uma D. Relationship between Maternal Health Services and Maternal deaths due to Direct Obstetric causes over five-year period in Karnataka- An Equity focused Evaluation. BMJ Global Health. 2016;1:A2-A.

Government of India, Millinium Development Goals India country Goals, 2015:P10.

Registrar General of India. Special bulletin on maternal mortality in India 2010-12. New Delhi: Office of the Registrar General of India; 2013. Last accessed on 5 May 2015.