Abstract

investigation of nurses/midwives knowledge on the management of pre-eclampsia and eclampsia among women at the Buea regional hospital. This study entitled “Investigating nurses\midwife’s knowledge on the management of pre-eclampsia and eclampsia “was carried out at the Buea Regional Hospital from December 2018 and April 22\2019. The sample size was 40 nurses/midwives working at Regional Hospital Buea and the sampling technique was a convenient sampling method.

The main instruments used for data collection was a questionnaire designed according to the objectives of the study. Pretesting of questionnaires was done at Regional Hospital Limbe. The purpose of the study was to improve the knowledge of the management of pre-eclampsia and eclampsia.

The general objective of this study was to Investigate nurse\midwives’ knowledge\prae4ce on the management of pre-eclampsia and eclampsia. In view of drawing up strategies to bridge any gab, specific objectives were ‘To investigate nurses\midwives knowledge on the definition, diagnose, possible complications and preventive measures of pre-eclampsia and eclampsia, also to Investigate nurses\midwives knowledge on the management of the disease and lastly to investigate nurse\midwives knowledge on the challenges faced in the management of pre-eclampsia and eclampsia

From the findings of this study, it was realized that 100% of nurses/midwives had knowledge of the definition, 80% know how it can be prevented and 60% have challenges. Thus it was concluded that 100% of nurses\midwives of Regional Hospital Buea have knowledge about pre-eclampsia and eclampsia.

However, some nurses and midwives do not have adequate knowledge of how to manage a woman with pre-eclampsia and eclampsia. As a recommendation, the Hospital should give opportunities to health personnel every month to research and present on challenging health-related topics such as pre­eclampsia and eclampsia, as this will help refreshed and widen their scope of knowledge in the field.

CHAPTER ONE

GENERAL INTRODUCTION

1.0 INTRODUCTION

Pre-eclampsia is a pregnancy induce hypertension, in association with proteinuria, with or without oedema noticed after the 20the week of pregnancy and eclampsia is defined as the occurrence of one or more convulsions usually superimposed on pre-ecampsia (WHO 2008). Approximately 2-3 % of all pregnant women will develop pre-ecampsia (RCOG2006) and 11% of first pregnancies (Villar et Al 2004).

According to WHO 2008, pre-eclampsia complicated up to 10% of all pregnancies and account for nearly 20% of all leading causes of maternal mortality worldwide-eclampsia /eclampsia account for more than 50,000 deaths per year worldwide and the developing countries carries 99%.

According to proffessor Leke Ivo Robertin 1987, the incidence of pre-eclampsia in Cameroon was 7.7% and complicates 0.2-0.5% of all pregnancies. pre-eclampsia in Cameroon constitute the fifth cause of maternal mortality and the second cause of prematurity and dysmaturity.

Pre-eclampsia remains one of the most common cause of death worldwide (Chhabra and Kakani 2007, Villar et Al 2004) the majority of women died  from intracranial hemorrhage, inadequate antihypertensive therapy was the most  common source of the substandard car ( Lewis 2007).

Bedsides it is associated with five four increase in perinatal mortality-eclampsia and eclampsia is known as a disease of theories due to the numerous school thought that drive around 400BC, who stated that headache accompanied by heaviness and convulsion during pregnancy was considered bad.

This was the earliest suggestion that there may be a specific entity with an unhealthy pregnancy, while this was the earliest recognition of disease, the only remedies were attempts to bring the four body’s humor (fluid ) (blood, phlegm, yellow bile and black bile) “into balance”(Demand,1994;Green, 1985) through altered diets, purging and blood _letting.

The American College of obstetricians and gynaecologist and the United Nation Organization recognize four categories of hypertension in pregnancy. This include chronic hypertension, gestational hypertension, preeclampsia/eclampsia and superimposed eclampsia. Risk factors include obesity, family history of hypertension, alcohol, stroke left ventricular hypertrophic (Pierre 2011)

hypertension disorders are a major cause of maternal death mortality and morbidity and leads to about 10 to 15 % of maternal death worldwide especially in developing countries. severe forms of hypertensive disorders include pre-eclampsia and eclampsia which are a leading cause of maternal death in many parts of the world. About 30% of pregnancy are associated with chronic hypertension while 70% of cases occurred in pregnancy are associated with women without the history of hypertension.

Pre-eclampsia is a multi-system disorder of unknown cause unique to pregnancy while preeclampsia complicates 6 to 10 % of all pregnancy in the United States, the incidence tends to be higher in underdeveloped countries (Jean 2015).

pre-eclampsia is a pregnancy specific disorder that has a work wide prevalence 5 to 8% it is one of the main causes of maternal and perinatal mortality and mortality globally be and account for 50000 to 60000 death annually with a predominance in the low and.  middle income country (P Gathiram 2016). preeclampsia or eclampsia can develop during pregnancy or delivery and its clinical presentation is characterized by hypertension, proteinuria and edema (Chun ye,2011).

According to (Mary ,2014) The prevalence is however higher than o.3% reported on the eclampsia by Item and Ebaku in Calabar – Nigeria. pre-eclampsia could be managed ones detected such that they are prevented from progressing to eclampsia. Eclampsia is the end stage of the disorder characterized by generalizing seizure.

The distribution of patients by age and parity revealed that the majority of the patient 44.1% where nulliparous which is lower than the report of 81.4%from Benin kudu but similar to the report of 49.4% from the University of Nigeria teaching hospital Enugu.

This is preeclampsia is a disease of the nulliparous, the cause of preeclampsia is diverse that immune maladaptation of the premiere gravida is responsible for the higher incidence of preeclampsia in this group per cent reported in Lagos, Benin and Sokoto respectively. the population rate of pregnancy hypertension varies substantially in high income countries ranging from 4 to 10%, including preeclampsia rate from 2 to 5%

In Cameroon the diagnosis of hypertension is based on the criteria defined by the national high blood education programmed working group on the high blood pressure in pregnancy ,severe pregnancy was defined by one or more of the following criteria blood pressure greater than 160/110mmhg, proteinuria greater than 3.5g/24hrs, original (>600m/24hrs),UGR (> than 10%), oligoamnios symptoms suggesting end-organ failure such as headache , visual disturbance , epigastric pain ,medical complication including pulmonary edema acute renal failure hepatitis, hematoma’s occurrence of convulsion not attributed to other condition in a patient with preeclampsia was considered as eclampsia will record data regarding demographic parameter, gestational age ( determined by last menstrual period when known or first trimester  obstetrical ultrasound ) medical condition such as hypertension, diabetes mellitus, history of smoking , presenting sign and symptom, blood pressure on admission, laboratory evaluation on admission FBC, livre , eczema urea, uric acid , coagulation profile and 24hrs proteinuria. We examined maternal and perinatal outcome for severe preeclampsia and eclampsia in 3 reference hospital of Yaoundé the capital city of Cameroon.

We found that the median gestational age at diagnoses was 37 weeks of gestation and caesarean section rate where 42.6% and 75% respectively for the general study population and for women had delivery within 24hrs followed the diagnosis of severe preeclampsia. All maternal death in 28 to 33-week gestational age group. primiparous young women with low socio-economic status are the most typical preeclampsia cases

1.1 Problems Statement

In the happy process of bringing forth life, difficulties may arise leading to the death of the mother, the baby or both, hence disrupting the plans of attending the fourth and the fifth-millennium goals. Most death due to preeclampsia/eclampsia in the process of bringing forth life is avoidable since medical solutions to these conditions to these conditions are available.

The most difficult to overcome is not the disease itself but how it is being managed. Therefore, assessing mother’s knowledge on the management of pre-eclampsia and eclampsia is of   primary important to know the care they provide to women presenting with preeclampsia which is very

1.2 Research Questions

Do mother’s in the Regional hospital have adequate knowledge of pre-eclampsia?

How demographic factor influence knowledge of pre-eclampsia in Regional hospital Buea.        

Objectives

General objectives

To assess the mother’s knowledge of pre-eclampsia and eclampsia in Buea regional hospital

Specific objectives

To Know what knowledge, do an individual have on pre-eclampsia/ eclampsia

To investigate a mother’s knowledge of the complication on pre-eclampsia/eclampsia

To investigate mother’s knowledge on the management on pre-eclampsia/ eclampsia.

  investigation of nurses/midwives knowledge on the management of pre-eclampsia and eclampsia among women at the Buea regional hospital ,     investigation of nurses/midwives knowledge on the management of pre-eclampsia and eclampsia among women at the Buea regional hospital,     investigation of nurses/midwives knowledge on the management of pre-eclampsia and eclampsia among women at the Buea regional hospital,     investigation of nurses/midwives knowledge on the management of pre-eclampsia and eclampsia among women at the Buea regional hospital