ABSTRACT

Preeclampsia is a pregnancy specific hypertensive disorder usually occurs after 20 week of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. Preeclampsia is a condition that pregnant women develop and it affects both the mother and fetus. This study was carried out from January 27 to 27 February 2023 for a period of a month at Mount Mary Hospital Buea located in the south west region of Cameroon. The main objective of the study was to assess the level of knowledge of pregnant women attending ANC on the consequences of preeclampsia. A quantitative cross-sectional study research design was used. In this light, pregnant women attending ANC were assessed on the causes, prevention and complication of preeclampsia.  About 56% of pregnant women attending ANC (28) were married while 36% (18) were single. Results reveals that 32 (74.4%) of the pregnant women attending ANC had no understanding on the causes of preeclampsia while 11 (26.2%) had understanding on the causes of preeclampsia. Results also showed that 29 (69.2%) of the pregnant women attending ANC had no understanding on the prevention of preeclampsia while 13 (31.1%) had understanding on the prevention of preeclampsia. Another results revealed that 34 (81%) of the pregnant women attending ANC had no understanding on the complication of preeclampsia while 8 (19%) had understanding on the complication of preeclampsia. Most of the pregnant women attending ANC do not know the causes, prevention and complication of Preeclampsia. The lack of understanding may be due to lack of planned preeclampsia educational or awareness program among pregnant women attending ANC at Mount Mary Hospital.

Key words: Preeclampsia, Pregnant women, Causes, Prevention, Complication

CHAPTER ONE

INTRODUCTION

1.1 Background

Preeclampsia is a pregnancy specific hypertensive disorder usually occurs after 20 week of gestation. It is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. Preeclampsia is a condition that pregnant women develop and it affects both the mother and fetus. Although preeclampsia and high blood pressure may be linked but they are two different conditions. Nearly one-tenth of maternal deaths in Asia and Africa and one-quarter of maternal deaths in Latin America are associated with hypertensive disorders of pregnancy (WHO, 2014). Among the hypertensive disorders, preeclampsia has the greatest impact on maternal and newborn morbidity and mortality. Yet the majority of deaths related to preeclampsia could be avoided if pregnant women knowledge on the consequences are improved upon during ANC and received timely and effective care (WHO, 2014).

In Ethiopia, the major direct obstetric complications including preeclampsia account for 5% of the maternal deaths. Unlike deaths due to other direct causes, preeclampsia related deaths appears to be increasing and linked to multiple factors, making prevention of the disease a continuous challenge (Whitney, 2017). Approximately 2% to 10% of pregnancies are affected by preeclampsia globally, defined by the development of hypertension and proteinuria after 20 weeks gestation. In the absence of proteinuria, additional features contribute to diagnosis (i.e. thrombocytopenia, renal insufficiency, and impaired liver function, pulmonary edema cerebral or visual symptoms). Preeclampsia is the second leading cause of maternal mortality worldwide. In the United states the rate of preeclampsia increase from 3.4% in 1980 to 3.85 in 2010, with the proportion of severe cases also increasing. (East et al., 2011). Preeclampsia is a multisystem disorder of unknown etiology, unique to pregnancy while preeclampsia complicates 6% to 10% of all pregnancies in the United States; the incidence is believed to be even higher in underdeveloped countries (Jean et al., 2014). In Cameroon, past history of preeclampsia was found in 14.95% of pregnancy (Jean et al., 2014). Globally, 76,000 women and 500,000 babies die each year from this disorder. Furthermore,

WHO estimated the incidence of preeclampsia to be seven times higher in developing countries than developed countries? Which include that, a pregnant woman in low-resource countries are at a higher risk of developing preeclampsia compared to those in high resource countries (developed countries). Reports indicate that patients’ knowledge about a disease or a condition has significant benefits on compliance to treatment and helps to abate complications associated with the disease. One major difficulty in combating preeclampsia is the late reporting of women to healthcare centers following an experience of a sign or symptom. This emphasizes the need for women to have adequate knowledge on the disease. For this to be achieved there is the need to assess the baseline knowledge of pregnant women. Previous studies in a few countries in Africa indicate that the knowledge on preeclampsia of women is generally low. Pre-eclampsia has been defined as a disease of first pregnancies. The association between primiparity and pre-eclampsia is so widely accepted that it is at the core of several pathophysiological theories. For example, it has been proposed that pre-eclampsia is the consequence of a maternal immune reaction against paternal antigens expressed in the placenta and that this reaction might result in defective trophoblast invasion and subsequent placental dysfunction. The lower risk of pre-eclampsia among multiparous women has been attributed to desensitization after exposure to paternal antigens in the placenta during previous pregnancies.1 2 The lower risk has also been attributed to smoother trophoblastic invasion after modification of maternal spiral arteries during the first pregnancy.

 1.2 Problem Statement

Preeclampsia has the greatest impact on maternal mortality which complicates nearly a tenth of pregnancies worldwide (WHO, 2017). It is the second leading cause of direct maternal death and directly responsible for 70,000 maternal deaths annually at the global level (Abalos et al., 2017) although the exact prevalence of morbidity and mortality related to preeclampsia is not reported in the developing countries. The majority of deaths related to preeclampsia could be averted by evidence-based, effective, and timely interventions by increasing women’s knowledge and changing attitudes towards preeclampsia (Townsend et al, 2016). Preeclampsia has been proven to have the following negative effect such as damage to the kidneys, liver, lung, heart, or eyes, and may cause a stroke or other brain injury, chronic hypertension, diabetes mellitus, cerebrovascular disease, thromboembolism and even impaired memory. A study conducted in Cameroon indicated that 61.1 % of the study participants did not know the consequences of preeclampsia (Hermann et al., 2016).The above mention, prompted the research on; pregnant women’s knowledge on the consequence of preeclampsia among women attending ANC.

1.3 Rational

Approximately 10% of maternal deaths are associated with preeclampsia and eclampsia. Preeclampsia has remained a public health threat to both developed and developing countries. Creating awareness on the consequence of preeclampsia among pregnant women will reduce morbidity and mortality for both fetus and mother.

1.4. Research questions

1. Do pregnant women know the causes of preeclampsia?
2. What is the level of understanding on the prevention of preeclampsia among pregnant women attending ANC?
3. Do pregnant women attending ANC understand the consequence of preeclampsia?

1.5. Objectives

1.5.1 Main objective of the study

To assess the level of knowledge of pregnant women attending ANC on the consequences of preeclampsia

1.5.2 Specific objectives.

1. 1. Assess the level of pregnant women understanding on the causes of preeclampsia.
2. Evaluate pregnant women attending ANC level of understanding on the prevention of preeclampsia.
3. Evaluate the level of awareness of the complication of preeclampsia among pregnant women attending ANC.