Maha makes anomaly scan mandatory for high-risk pregnant women at 18-20 weeks

Anomaly scan is a specialised ultrasound test that helps detect 11 different structural and genetic abnormalities in the fetus at an early stage, which could affect its development

In a move to reduce infant deaths caused by congenital anomalies, the Maharashtra government has made it mandatory for high-risk pregnant women to undergo an anomaly scan between 18 and 20 weeks of pregnancy. The Public Health department issued the general resolution (GR) on February 17. The move will help to identify congenital abnormalities in fetuses at an early stage, allowing for appropriate treatment for a better outcome, health officials said on Monday.

According to the officials, women in the ‘high-risk’ category include very young mothers, mothers whose previous child was born with a congenital anomaly, suffered recurrent pregnancy losses and stillbirth with a suspected anomaly, etc. (REPRESENTATIVE PHOTO)

According to the officials, women in the ‘high-risk’ category include very young mothers, mothers whose previous child was born with a congenital anomaly, suffered recurrent pregnancy losses and stillbirth with a suspected anomaly, have diabetes mellitus (pre-gestational), cardiac defects, epilepsy, uncontrolled thyroid disorders, obesity, folic acid deficiency, severe anemia, Vitamin A excess, etc.

The anomaly scan is a specialised ultrasound test that helps detect 11 different structural and genetic abnormalities in the fetus at an early stage, which could affect its development. Identifying potential birth defects early allows for timely medical intervention or, when required, legal termination of pregnancy.

Previously, the anomaly scan was not mandatory in the state. However, private hospitals suggested that pregnant women voluntarily undergo the scan. Following the recent GR, all high-risk and eligible pregnant women (as per indications or advised by their treating specialist) must undergo an anomaly scan between 18 and 20 weeks of pregnancy.

As per the GR, the directive applies to both government and private hospitals. High-risk pregnant women are entitled to free scans at government facilities, but those who opt for private hospitals must bear the cost. The resolution notes that private hospitals provide nearly 50% of antenatal and postnatal care in Maharashtra, making uniform implementation critical.

The district health officers and civil surgeons have been asked to monitor implementation in both public and private healthcare facilities. Professional bodies such as the Indian Medical Association (IMA) and FOGSI (Federation of Obstetric and Gynaecological Societies of India) have been urged to support awareness and compliance.

The directives were issued following an analysis of child mortality data over the past three years in the state. As per the analysis, congenital anomalies consistently rank among the top five causes of child deaths in the state. According to official records, congenital anomalies accounted for 6.34% of child deaths in 2023–24, rising to 6.6% in 2024–25 and 6.7% in 2025–26 (up to October 2025), health officials said.

Dr Sunita Tandulwadkar, president, FOGSI and Head of IVF & Endoscopy at Ruby Hall Clinic, Pune, said early detection gives families time and choices.

“If an abnormality is severe and life-limiting, it allows for timely confirmation, counselling, and - where appropriate - consideration of termination within the legal pathway,” she said. “Many findings are treatable, and early detection also helps plan delivery at the right centre with neonatal support and surgical backup.”

Dr Tandulwadkar also highlighted that many expecting mothers miss the anomaly scan due to reasons like unplanned pregnancy or late recognition, access barriers in remote areas, low perceived importance and anxiety, and avoidance stemming from the fear of “bad news.

“The impact becomes meaningful when scanning is timely, high-quality, and linked to referral and newborn care pathways, and not just a routine scan,” she added.

Dr Sandeep Sangale, joint director, State Family Welfare. Bureau (SFWB), also stressed on the importance of early detection.

“It not only improves outcomes but can also prevent avoidable suffering for families. Government hospitals already provide anomaly scans free of cost to high-risk pregnant women under the Janani Shishu Suraksha Programme,” he said.

Dr Sangale further informed that orders have been issued to all district which has ultrasound machine to appoint radiologists to conduct the tests.

As per the official data from the health department, between April-November 2025, 96,620 high-risk expecting mothers were detected in Maharashtra. Of these 3,625 underwent anomaly scans; 216 fetuses were detected with fetal anomalies, and 177 pregnancies were terminated.