Effectiveness of saving babies lives care bundle in reducing stillbirth: A pilot study
The death of a fetus after 28 weeks of pregnancy but before delivery is known as stillbirth, and it continues to be a major public health issue in India. Fetal Growth Restriction is a disorder in which a fetus fails to reach its genetically predetermined growth potential and is a primary cause of stillbirths. One important risk factor for stillbirth is fetal growth restriction. The risk of stillbirth can be decreased by up to 40% by detecting FGR. Research indicates that impaired placental development and function can lead to reduced nutrient and oxygen supply to the fetus, resulting in FGR and increasing the risk of stillbirth.
These findings with the objectives of the Saving Babies' Lives Care Bundle (SBLCB), an initiative by NHS England introduced in 2016 to reduce stillbirths and early neonatal deaths. The importance of the SBLCB lies in its comprehensive approach to addressing multiple factors that contribute to stillbirths and neonatal deaths. By standardizing best practices across maternity units, the care bundle aims to improve outcomes for mothers and babies.
This study aimed to evaluate the Effectiveness of the Care Bundle in Reducing Stillbirth Rates and assess whether the care bundle enhances the early identification of FGR cases among the study population. By addressing these objectives, the study seeks to determine the feasibility of implementing these antenatal practices to reduce stillbirths in tertiary care in Tamil Nadu.
A quasi-experimental trial at IOG, Chennai (Nov 2022–Apr 2023), assessed the impact of the Saving Babies' Lives care bundle on maternal and fetal outcomes. Pregnant women (10–34 weeks) were divided into control and study groups. Outcomes, including stillbirth and fetal growth restriction, were analyzed using Chi-square tests for significance.
The results showed that the study group had zero stillbirths, whereas the control group had three stillbirths (8.33%), indicating a potential benefit of the Saving Babies' Lives Care Bundle (SBLCB) practice recommendations in reducing stillbirth rates. UAD was assessed in 48 women, with 27.08% showing a pulsatility index above the 95th percentile; 4.16% of them developed FGR, compared to 8.33% with normal UAD. Reduced fetal movements (<10 in 2 hours) were reported by 17.46%, with 6.34% developing FGR, while 7.93% with normal movements also had FGR. Furthermore, the study group's FGR fetuses had a higher mean birth weight (2.3 kg ± 0.43) than the control group (1.86 kg ± 0.43), which may indicate better fetal growth outcomes.
The study found no statistically significant difference in the diagnosis of fetal growth restriction (FGR) or mode of delivery between the study and control groups. However, nil still birth was not recorded out of nine FGR in the study group that received saving babies’ life care bundle fetus emphasizing the positive fetal outcome.
Source: Niveditha G R et al. / Indian Journal of Obstetrics and Gynecology Research 2026;13(2):306–314
