Karnataka to procure gadgets to curb neonatal deaths

Bengaluru: To improve foetal health screening in government health facilities and reduce risk of neonatal mortality in the state, the government is now procuring 385 NST (non-stress test) machines that monitor foetal heart rate.

These machines will also be able to provide automatic foetal heart rate interpretation and indicate if the foetus is in distress based on heart rate variability as it develops, something trained nurses and gynaecologists do manually, based on readings of the foetus' heart rate.

These machines are especially useful to screen high-risk pregnancies, helping doctors consistently monitor the heart rate and well-being of the foetus right up to delivery and catch any heart rate anomalies early to prevent stillbirths and health complications such as irreversible brain damage potentially arising due to low oxygen (hypoxia).

The government plans to bring in these machines to supply to taluk hospitals, community health centres and maternity health centres in Karnataka, a source from the Karnataka State Medical Supplies Corporation Ltd (KSMSCL), the agency that has invited bids for these machines at a total estimated cost of Rs 13.62 crore, told DH.

In these centres, where a gynaecologist might not always be present, the automatic interpretation will enable staff nurses and medical officers ascertain whether the pregnant woman needs to be referred to a tertiary hospital for additional care before delivery, said Dr Savitha C, medical superintendent, Vani Vilas Hospital, Bengaluru.

Currently, private hospitals and district-level government hospitals have the NST machine, so doctors believe introducing this in the primary and secondary centres will reduce the burden on some hospitals.

"We want to bring these machines to more government hospitals so that doctors can detect any foetal heart conditions much earlier and help in reducing neonatal and infant mortality in the state," Health Minister Dinesh Gundu Rao told DH.

According to the Sample Registration System (SRS) report of 2020 released in September 2022, the Neonatal Mortality Rate (NMR) in India was 20 per 1,000 live births.

Earlier this year, the state health minister noted that the neonatal mortality rate in Karnataka was 14 per 1,000 live births, in response to a question posed in the February Assembly session.

Dr Hemavathi Srinivasan, a gynaecologist in a private hospital in the city, noted that the machine also assesses uterine contractions before delivery and can be used in high-risk pregnancies from 30 weeks onwards, since they require constant monitoring.

"This is especially very useful in a government setting due to the higher volume of high-risk pregnancies they see, and will help ensure timely interventions when needed," she said. 

"There is no recommendation now to use these machines in low-risk pregnancies. This is used especially for diabetic mothers or pregnant women with risk factors such as age extremes and health conditions that can increase the risk of intrauterine death, and help doctors pick up any imminent danger to the baby during labour due to low oxygen or irregular heart beat," said Dr Sriprada Vinekar, obstetrician and gynaecologist in a private hospital.

Safe conception

* NST (non-stress test) machines monitor foetal heart rate

* Provide automatic foetal heart rate interpretation and indicate if foetus is in distress

* Useful to screen high-risk pregnancies, helping doctors consistently monitor heart rate

* Help catch any heart rate anomalies early to prevent stillbirths and health complications