Pre-Conception And Pre-Natal Diagnostic Techniques Research Articles

Knowledge and attitude of antenatal mothers on the preconception and prenatal diagnostic techniques act attending Government Maternity Hospital in Andhra Pradesh: A cross-sectional study

Background: Girl children are vulnerable to gender biases throughout the economic and social strata. From the moment of conception, a girl’s existence is an ongoing struggle for survival, development, and growth. Gender equality has gained recognition in the past 10 years as essential to a country’s social and economic progress and overall health. Aims and Objectives: The aim of the study was to know the awareness and attitude of antenatal mothers regarding the preconception and prenatal diagnostic techniques (PCPNDT) act, gender preference, and their awareness regarding related social issues. Materials and Methods: A hospital-based cross-sectional study was conducted after obtaining ethics committee approval and consent from 200 antenatal mothers attending a maternity hospital from September to December 2022. Data were collected using a predesigned, pre-tested, semi-structured questionnaire. The analysis was done with Statistical Package for the Social Sciences software version 26.0. Results: Out of 200 study subjects, 80% were in the age group of 19–25 years, 60.5% were aware of the PCPNDT act, and 43.8% of mothers had knowledge about the PCPNDT act from hospital sources. Of the 56% of mothers who preferred a male child, 35.7% said it was first being a girl child. In this study, awareness of the PCPNDT act was significantly associated with age, area of living, religion, education, occupation, and socio-economic status, but not with type of family. Conclusion: Despite better knowledge regarding the PCPNDT act, the attitude toward sex determination, female foeticide, and son preference has to be changed. For this reason, strict implementation of the PCPNCDT act is essential.

Removing Barriers to Emergency Medicine Point-of-Care Ultrasound: Illustrated by a Roadmap for Emergency Medicine Point-of-Care Ultrasound Expansion in India.

Point-of-care ultrasound (PoCUS) has a potentially vital role to play in emergency medicine (EM), whether it be in high-, medium-, or low-resourced settings. However, numerous barriers are present which impede EM PoCUS implementation nationally and globally: (i) lack of a national practice guideline or scope of practice for EM PoCUS, (ii) resistance from non-PoCUS users of ultrasound imaging (USI) and lack of awareness from those who undertake parallel or post-EM patient care, and (iii) heterogeneous pattern of resources available in different institutes and settings. When combined with the Indian Preconception and Prenatal Diagnostic Techniques (PCPNDT) Act, this has led to the majority of India's 1.4 billion citizens being unable to access EM PoCUS. In order to address these barriers (globally as well as with specific application to India), this article outlines the three core principles of EM PoCUS: (i) the remit of the EM PoCUS USI must be well defined a priori, (ii) the standard of EM PoCUS USI must be the same as that of non-PoCUS users of USI, and (iii) the imaging performed should align with subsequent clinical decision-making and resource availability. These principles are contextualized using an integrated PoCUS framework approach which is designed to provide a robust foundation for consolidation and expansion across different PoCUS specialisms and health-care settings. Thus, a range of mechanisms (from optimization of clinical practice through to PoCUS educational reform) are presented to address such barriers. For India, these are combined with specific mechanisms to address the PCPNDT Act, to provide the basis for influencing national legislation and instigating an addendum to the Act. By mapping to the recent Lancet Commission publication on transforming access to diagnostics, this provides a global and cross-discipline perspective for the recommendations.

A Study to Assess the Knowledge on Female Foeticide and Attitude towards Gender Preference among Prim Gravida Mothers attending OPD in a selected hospital with A view to Provide Informational Booklet

Background of the study: Female feticide is the process of finding out the sex of the fetus and undergoing abortion if it is a girl. This is one of the most prevalent issues today. The preference for the male child dates back into history and obviously, therefore, female feticide has long been practiced in Indian societies. With the advancement in technology and development of easier and cheaper techniques, female feticide has spread throughout India. The government has amended the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act of 1994 that criminalized prenatal sex screening and female feticide, making it illegal in India to determine or disclose the sex of fetus to anyone. Objectives: To assess the knowledge and attitude of prim gravida mothers regarding Female Foeticide. Methodology: this study was done with non-experimental research survey research design. Study was done in KC General Hospital, Bangalore. Sampling technique for selecting 60 samples was non – probability convenience sampling technique. Data collection was done with self – structured knowledge questionnaire and likert scale was developed to assess attitude of the samples. Data collection period was for 30 days and interview method was employed in collecting data and the collected data were analysed through descriptive and inferential statistics. Results: The present study shows the overall knowledge total score of mean and standard deviation scores were 7.52 2.67 and the overall attitude mean and standard deviation score was 37.0 4.30. the correlation between knowledge and attitude was 0.359 which indicates mild positive correlation Conclusion: The samples in the study had inadequate knowledge and unfavourable attitude towards female feticide and gender differences. The researcher administered information booklet to the samples to increase their knowledge and to develop their attitude.

A Case Report of Beckwith-Weidemann Syndrome: An Overgrowth Anomaly

Beckwith-Wiedemann Syndrome (BWS) is an overgrowth anomaly of congenital origin that has low prevalence. However, among the congenital anomalies of overgrowth, it has high prevalence. Typical features are macroglossia, macrosomia, omphalocele and anterior abdominal wall defects. Though Genetic, but it’s mechanism of occurrence is not clear. Many researchers have found correlation between methodology of Assisted Reproductive Techniques and BWS. Future research for the improvement of the prenatal diagnostic techniques would help the multidisciplinary team to treat these congenital diseases. In the present case, the diagnosis of BWS was made by ultrasound conducted in Radiology Department after filling Preconception and Prenatal Diagnostic Techniques (PCPNDT) form in the institute at gestation of 29+6 weeks and after two days of diagnosis, unfortunately patient reported to our hospital emergency with intrauterine foetal demise.

Awareness about Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act among The Married Women: An Observational Cross Sectional Study

Foetal sex determination and sex-selective abortions by medical professionals has grown today into a thousand crore industry. In the Pre-Natal Diagnostic Technique (Regulation and Misuse) Act, 1994 amendment was done and titled as Pre-Conception and Pre-Natal Diagnostic Technique (Prohibition of sex selection) Act (PC-PNDT ACT) 2003 for improvement in technology-related sex determination regulation. Aims and Objectives: 1. To find out awareness about PCPNDT Act among the married women in the community and to determine their sociodemographic factors influencing this awareness. 2. To assess the reasons for gender Based family composition and violation of laws. Materials and Methods: A hospital-based observational study was carried out among the married women in the reproductive age group attending Dr. Vithalrao Vikhe Patil Memorial Hospital in Ahmednagar District. The 100 study participants were administered a preformed questionnaire of about ten questions on the PCPNDT Act. The data obtained was analyzed and expressed in percentage, and statistical analysis was done. Results: The majority of the participants (81%) were aware of the act amended by the Government for the prevention of female feticide. A large number of participants (60%) would prefer to know the sex of their unborn child, and also 9% of them would terminate the pregnancy if the sex was revealed to be a female. A large number of participants (85%) were aware that there is punishment for both doctors who facilitate and patients who seek pre-natal sex determination. Conclusion: The study found that most of the participants were aware of the possibility and techniques of pre-natal sex determination. More than half of the participants were aware of the law enacted by the Government. Still, they should be educated about the importance of maintaining the falling sex ratio and prevention of female feticide.

Awareness and attitudes about prenatal sex determination among pregnant mothers and their perceptions regarding Pre-Conception and Pre-Natal Diagnostic Techniques Act

Background: Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act was introduced in India to provide a legal framework to support prevention of fetal foeticide and maintains a healthy sex ratio. Even after implementation of the act, illegal testing and abortions are reported. Awareness and attitudes of pregnant women will give an insight into this problem. Objectives: The objectives of this study were to study the level of awareness and attitudes among pregnant mothers at Goa Medical College toward pre-natal sex determination and female foeticide, and to study the perceptions among them regarding the PCPNDT ACT. Materials and Methods: This cross-sectional study was carried out among 100 consecutive pregnant women admitted from June 1 to August 31, 2019, in the antenatal wards of the Department of OBG at Goa Medical College, Bambolim, Goa. Results: Two-thirds (76%) of the pregnant mothers were aware of the PCPNDT Act and majority (83%) were aware that prenatal sex determination is an offence. The majority (81%) of the mothers had no specific expectations regarding the sex of the child, whereas 8% preferred having a male child and 11% preferred a female child. The most common reason for male child preference was found to be pressure from other family members. Conclusion: The majority of the pregnant mothers from Goa were aware of the PCPNDT Act and most of them do not have a specific preference for male child.

Ultrasound in pain and musculoskeletal interventions: A nation-wide survey of practicing pain physicians

Background: Conventionally, fluoroscopy has been used by Pain Physicians to perform minimally invasive pain and spine interventions. In recent times, the use of ultrasound (US) in interventional pain management (IPM) has increased significantly. However, there is no Indian data with regard to US use for IPM. Hence, the musculoskeletal (MSK) pain special interest group (SIG) of the Indian Society for Study of Pain (ISSP) decided to conduct a survey among Indian Pain Physicians to get an insight into various aspects of US in IPM. Materials and Methods: The MSK Pain SIG of ISSP developed the questionnaire, and the same was sent to ISSP members with an active E-mail ID. The questionnaire was mainly about US availability at the workplace, training received for US-guided IPM, barriers to US use, and suggestions to improve widespread US use. Results: The response rate was only 15% (176 out of 1160 physicians responded). The majority (69.3%) of the respondents used both US and fluoroscopy and the US machine was available in 76.1% pain clinics. Over three-fourth reported that they have received training for US-guided IPM. Only half of the participants expressed that they received US training during pain fellowships. Barriers for US use included lack of formal teaching/training of US, availability of US machine, and preconception and prenatal diagnostic techniques (PCPNDT) act. The future strategy includes taking measures for US availability for pain physicians, mandatory US training during fellowships and regular workshops. Conclusion: This first-of-its-kind survey provides many valuable insights on US availability, barriers, and future suggestions. ISSP can consider joint collaboration with other organizations on dilution of existing law and take measures to improve US training and its widespread use.

Survey of Point-of-Care Ultrasound Uptake in Indian Neonatal Intensive Care Units: Results and Recommendations

Objectives: Point-of-care ultrasonography (POCU) refers to the process of ultrasound performed at the bedside by treating physicians, for the ongoing assessment of disease, evaluation of response to treatment, and assistance in procedures. This study was conducted to assess the current utilization, training, and barriers to the implementation of neonatologist-performed POCU (NP-POCU) in Indian neonatal intensive care units (NICUs). Methods: A survey questionnaire was disseminated to practicing neonatologists in India via an online survey tool from July 2017 to September 2017. The questionnaire addressed the information related to the availability of NP-POCU services, indications for its use, perception among neonatologists about its usefulness, training for NP-POCU, and access to pediatric cardiology and radiology services. Results: The overall response rate was 78%. A total of 72% respondents reported having access to NP-POCU services in their units. Neonatologist-performed POCU (NP-POCU) was used most frequently for cranial ultrasound (97%), functional echocardiography (90%), and evaluating line position (67%). Majority (92%) of the units had no training program for NP-POCU. The most common reasons cited for not having NP-POCU services were non-availability of trained personnel to perform POCU (50%) and strict Pre-conception and Prenatal Diagnostic Techniques (PC-PNDT) Act (50%). Conclusions: Neonatologist-performed point-of-care ultrasonography is being increasingly utilized in Indian NICUs. However, there is a lack of structured training and guidelines for its use. Non-availability of trained personnel and strict PC-PNDT Act are major barriers to its implementation. We recommend that accredited training programs and standardized guidelines be established for the safer use of NP-POCU in India.

Awareness regarding pre-conception and pre-natal diagnostic techniques act among women in a rural community of Puducherry

Context: Child sex ratio of the nation has been declining since few decades. Aims: The objectives of this study are to find out awareness about Pre-conception and Pre-natal Diagnostic Techniques (PC-PNDT) act among ever-married women and to determine their sociodemographic factors influencing this awareness. Settings and Designs: This was a cross-sectional study conducted at a rural primary health center of Puducherry. Subjects and Methods: A cross-sectional study was conducted at a rural primary health center in Puducherry among 200 ever-married women in reproductive age group. Information regarding their awareness about PC-PNDT Act was collected using a semi-structured questionnaire. Statistical Analysis Used: Chi square-test was done for analyzing the categorical data. Results: Among the ever-married women, about 30 (15%) were not aware about the provisions of PC-PNDT Act, while 170 (85%) were aware about it. No significant association was found between sociodemographic variables and awareness about the Act. Conclusions: Majority of the ever-married women in the study setting were aware of the provisions of PC-PNDT Act.

Health and Welfare of Women and Child Survival: A Key to Nation Building.

Health of women has a profound effect on the health and welfare of communities, countries and the world at large. A large number of social, economic, educational, political and religious dimensions impact the lives of girls and women with repercussions on their health and status in society and welfare of their children. It is a sad reality that a large number of children, adolescents and women worldwide have limited or no access to essential health care services, nutrition and education. Gender inequity and discrimination against girls cannot be bridged unless there are equal opportunities for healthcare and education for boys and girls. The International Day of the Girl Child is celebrated on 11th October to create global awareness about issues of gender inequity, bias, right to education, nutrition, medical care and protection against discrimination, violence, genital mutilation and child marriages. There is a need to provide essential healthcare and nutrition to girls and women throughout their life cycle. Children are the foundation of a nation and mothers are its pillars, and no sensible government can afford to neglect the needs and rights of women and children. The government of India has launched several initiatives like National Plan of Action for the Girl Child, Preconception and Prenatal Diagnostic Techniques (PCPNDT) Act to curb female feticides and "Save Girl Child, Educate Girl Child" Yojana. But the real challenge is effective implementation of these programs without any leakage of funds and resources. The United Nations, through a series of conventions, has declared child marriages as a violation of human right. They have launched an ambitious global strategy for promotion of health of women, children and adolescents for achieving Sustainable Development Goals (SDGs) by 2030 with a focus on "Every Woman Every Child".

The Pre-Conception and Pre-Natal Diagnostic Techniques Act and its implication on advancement of ultrasound in anaesthesiology; time to change mindsets rather than laws.

Ultrasonography (USG) has a continuously expanding role in anaesthesiology, critical care and pain management and has enhanced and refined patient care. The Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act was established to counter the persistent problem of female foeticide in India. This unique problem which seems to be rooted in our social structure has indirectly impeded the evolution of USG as a widespread tool in medicine in our country. This brief review is aimed at highlighting the expanding role of USG in anaesthesia practice and training, nuances of the PCPNDT act and its implications on the growth and management of ultrasound technology in anaesthesia, in India.

Awareness and perception regarding PCPNDT Act and gender preference among mothers of under-five attending immunization clinic

Background: Falling sex ratio is signaling precipitation of demographic catastrophe in India. Female feticide, male child preference, and gender inequities are to be blamed. Objective: To study awareness and perception regarding Preconception and Prenatal Diagnostic Techniques (PCPNDT) Act among mothers of under-five attending immunization clinic and gender preference among them. Materials and Methods: A Cross-sectional study was carried out among 200 mothers of under-five attending immunization clinic at Government Medical College, Nagpur, during April–June 2014. Data were collected by interview using semistructured pro forma after obtaining written consent of mothers. Data were presented in percentage, mean, range with SD, and X2-test as test of significance. Result: Majority of mothers 150 (75%) were aware about decreasing girls in India. One hundred and sixty-one (80.5%) mothers were aware about prenatal sex determination, and 61 (30.5%) knew that sonography is used for this purpose. Awareness about PCPNDT Act was 65%. Awareness was significantly associated with higher education, upper socioeconomic class, and working status. Although 85 (42.5%) mothers knew that punishment under PCPNDT is in the form of jail or monetary fine, none were aware about the correct penalty. Of 83 mothers desirous of more children, 33 (40%) preferred to have male child; while only 14 (17%) had preference for a female child. Preference for male child was significantly associated with the birth of previous female child. Conclusion: Awareness regarding PCPNDT Act is high among those with higher education, upper socioeconomic class, and working mothers. Preference for male child is significantly associated with the birth of previous female child.

Changing strategies of female foeticide in India: a never ending story

Once a young lady, walked in the OPD with history of bleeding per vagina for last 24 hours. It was a case of retained products of conception subsequent to induced incomplete abortion. Later we came to know that a team of local private doctors with portable ultrasound machine and MTP kits used to come in the study areas at night hours. This mobile team offered a package deal to the clients. Part one was sex determination test. When a female fetus was detected they offered to do induce abortions (on the spot). This is done in a clandestine way. The team used to leave after initiating the procedure. For any complication they were advised to go to hospital OPD presenting as P/V bleeding to avoid punishment under Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994. As we know every action has an opposite reaction. To prevent female feticides government enacted PNDT Act as an action. Reaction to this people started prenatal sex selection. Again the governmental action was amendment of Pre-Natal Diagnostic Techniques (Regulation and Prevention of misuse) (PNDT) Act, 1994 to PC-PNDT ACT. People's reaction was sex selection in a static van. Due to raids it was converted to mobile van. In our case study it is seen that, to avoid the PC-PNDT Act, people devised a newer strategy. A strategy for sex determination and female feticide by a mobile team with portable ultrasound machines. Our case study is important because we have just explored the tip of the iceberg only. A lot of efforts should be done. Until and unless the people understand the value of women in the society, this kind of reaction will take place again and again.

“If a woman has even one daughter, I refuse to perform the abortion”: Sex determination and safe abortion in India

In India, safe abortion services are sought mainly in the private sector for reasons of privacy, confidentiality, and the absence of delays and coercion to use contraception. In recent years, the declining sex ratio has received much attention, and implementation of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act (2003) has become stringent. However, rather than targeting sex determination, many inspection visits target abortion services. This has led to many private medical practitioners facing negative media publicity, defamation and criminal charges. As a result, they have started turning women away not only in the second trimester but also in the first. Samyak, a Pune-based, non-governmental organization, came across a number of cases of refusal of abortion services during its work and decided to explore the experiences of private medical practitioners with the regulatory mechanisms and what happened to the women. The study showed that as a fallout from the manner of implementation of the PCPNDT Act, safe abortion services were either difficult for women to access or outright denied to them. There is an urgent need to recognize this impact of the current regulatory environment, which is forcing women towards illegal and unsafe abortions.