CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2023; 33(01): 107-109
DOI: 10.1055/s-0042-1758875
Brief Report

Prioritizing Fetal Structural Abnormalities Over Risk for Pre-Eclampsia and Fetal Growth Restriction in the 20-24 Gestation Week Assessment in India: Missing the Woods for the Trees?

Rijo Mathew Choorakuttil
1   Department of Clinical Radiology, AMMA Center for Diagnosis and Preventive Medicine, Kochi, Kerala, India
Shilpa R Satarkar
2   Department of Clinical Radiology, Antarang Sonography and Colour Doppler Center, Satarkar Hospital, Tilaknagar, Aurangabad, Maharashtra, India
Lalit K. Sharma
3   Department of Clinical Radiology, Raj Sonography & X-Ray Clinic, Baiju Choraha, Nayapura, Guna, Madhya Pradesh, India
Anjali Gupta
4   Department of Clinical Radiology, Anjali Ultrasound and Colour Doppler Centre, Shanti Madhuban Plaza, Delhi Gate, Agra, Uttar Pradesh, India
Akanksha Baghel
5   Department of Clinical Radiology, Baghel Sonography Center, Harda, Madhya Pradesh, India
6   Department of Research, Chief Research Mentor, AMMA Education and Research Foundation, AMMA Healthcare Research Gurukul, Kochi, Kerala, India
› Author Affiliations


Aim To compare the magnitude of fetuses with congenital anomalies, pregnant women identified at high risk for preterm pre-eclampsia (PE) or with preterm PE, and with early fetal growth restriction (FGR) or high risk for FGR at the second trimester assessment at 20 to 24 weeks of gestation.

Methods A standardized trimester-specific protocol that included clinical and demographic details, fetal biometry, estimated fetal weight (EFW), fetal abdominal circumference (FAC), mean arterial blood pressure and fetal Doppler studies was used to identify high risk for preterm PE and FGR. The Targeted Imaging for Fetal Anomalies (TIFFA) scan was used to identify congenital anomalies. In addition, 95% confidence intervals of the point estimates were derived, and the p-value was estimated to assess the statistical significance of the difference in proportions.

Results Analysis of the data of 4,572 pregnant women screened between 20 and 24 gestation weeks showed a significantly lower prevalence (p < 0.001) of congenital abnormalities (3.81%) compared to women diagnosed with early PE (2.71%) or with a high risk for PE (4.00%) and women (6.80%) with early FGR or at higher risk for fetal growth restriction with both EFW and FAC < 10th percentile.

Conclusion The data on prevalence from Samrakshan show that the second-trimester assessment of pregnant women in India must expand its scope from the TIFFA scan to also focus on screening to identify women at high risk for preterm PE and FGR.

Work Attributed to

Indian Radiological & Imaging Association, IRIA House, C-5, Qutab Institutional Area, New Delhi-110016, India.

Publication History

Article published online:
11 December 2022

© 2022. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India