Impact of a Community‐Oriented Comprehensive Clinical and Ultrasound Care Model Integrating Risk Stratification, Fetal Doppler, Health Education and Low‐Dose Aspirin on Preeclampsia Rates in Central India

ABSTRACT Aim To determine the impact of a community‐oriented model integrating first‐trimester risk stratification, fetal Doppler and routine antenatal ultrasound on preeclampsia (PE) and perinatal mortality rates in a rural population of central India. Methods The program covered 168 public sector centres providing pregnancy care services to nearly 1500 pregnancies annually. First‐trimester assessments included measurement of mean arterial blood pressure, mean uterine artery pulsatility index, risk stratification for preterm PE, recommending low‐dose aspirin 150 mg for women at high risk for preterm PE, and health education for public sector community health workers, pregnant women and their families. Second and third trimester assessments included fetal biometry, growth, fetal Doppler studies of uterine, umbilical, middle cerebral arteries and estimation of the cerebroplacental ratio, staging and protocol‐based management of fetal growth restriction and individualised clinical management of PE. Results The analysis included 4808 pregnant women screened from September 2019 to May 2025. Childbirth outcomes were available for 4016 (83.5%) women. The first trimester screening protocol ( n = 2933) identified 4.2% ( n = 124) women only at high risk for preterm PE and 10.7% ( n = 313) women at high risk for both preterm PE and fetal growth restriction. PE was reported in 28 (0.7%) of the 4016 women with childbirth outcomes. The perinatal mortality rate was 16.4/1000 childbirths in 2025 compared to 37.0/1000 childbirths in 2016. Health education was provided to all screened pregnant women and healthcare staff of the healthcare centres. Conclusion The community‐oriented model reduced the magnitude of PE and perinatal mortality in this rural community.