1.1 Introduction
Eclampsia is a pregnancy-specific disorder characterized by hypertension, significant proteinuria, with or without edema (Kooffreh et al., 2014). Pre-eclampsia is the most common complication that occurs during pregnancy. Pre-eclampsia can be defined as the presence of a systolic blood pressure (sbp) greater than or equal to 140mmhg or a diastolic blood pressure (dbp) greater than or equal to 90mmhg or higher, on two occasions at least 4 hours apart in a previously normotensive patient. It can also be defined as a sbp greater than or equal to 160 mm hg or a dbp greater than or equal to 110mmhg or higher (when hypertension can be confirmed within minutes to facilitate timely antihypertensive therapy).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.
1.2 Background of Study
Globally and in the health care delivery system preeclampsia is a syndrome characterized by hypertension and proteinuria that occurs during the second and third trimester of pregnancy. It can cause disseminated intravascular coagulation, vasospasm, sodium retention, and seizures; the occurrence of seizures in a pre-eclamptic women marks the onset of eclampsia. The end stage of pre-eclampsia is eclampsia which is defined by generalized tonic-clonic seizures, with or without raised blood pressure and proteinuria, occurring during or after pregnancy with or without other identifiable cause. The cause is usually multifactorial including cerebral vasoconstriction, ischemia, vasogenicedema, or other pathology.
Pre-eclampsia is a pregnancy-specific disorder characterized by hypertension, significant proteinuria, with or without edema (Kooffreh, Ekott&Ekpoudom, 2014). Pre-eclampsia is the most common complication that occurs during pregnancy. It generally develops during the second trimester and affects about 1 in 20 pregnancies (Nordqvist & Liberto, 2017). It is multifactorial and forms an integral part of the continuum of hypertensive disorders of pregnancy. The end stage of pre-eclampsia is eclampsia (Kooffreh,et al.,2014). Pre-eclampsia is a disorder associated with high blood pressure and proteinuria during pregnancy (Bigdeli, Zafar, Assad & Ghaffar, 2013).
Although eclampsia occurs mostly in women with severe pre-eclampsia, there is no convincing test for predicting its onset. Many factors or medical conditions may influence the outcome of pregnancy, which in turn, may increase perinatal and maternal morbidity and mortality. One such condition is pre-eclampsia and eclampsia, which is characterized by an increase in blood pressure (BP), seizure, severe headache and edema (Marshall & Raynor, 2016). Although preeclampsia currently is a significant clinical problem, its impact is likely to increase as conditions that place a woman at risk for preeclampsia, such as diabetes and obesity, continue to become more prevalent. Together with other hypertensive diseases of pregnancy, it is one of the leading cause of maternal, fetal and neonatal mortality and morbidity especially in resource limited-settings where diagnosis and obstetric management are deficient (Sibai, 2010).
Therefore, in Northern Cross River State where the research was carried out, the activities that was conducted is to assess the Eclampsia Management amongst Midwives in Secondary Health Care Facilities.
1.3 Statement of Problems
Investigation revealed the eclampsia is one of the problems affecting women during pregnancy, labour and pueperium and is among the leading factor that causes maternal and perinatal mortality and morbidity in Northern Cross River State.
1.4 Aim and Objectives of Study
The aim of the study is to assess the Eclampsia Management amongst Midwives in Secondary Health Care Facilities in Northern Cross River State. In achieving this aim, the following specific objectives were laid out as follows:
- To identify how midwives managed eclampsia at the maternity hospital in Northern Cross River State;
- To determine the level of knowledge of midwives on eclampsia;
- To identify the strategies used for management of preeclampsia among midwives;
- To assess the outcomes of preeclampsia management among midwives; and
- To assess the knowledge, perception and management of eclampsia among midwives in Secondary Health Care Facilities.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- How does midwives managed eclampsia at the maternity hospital in Northern Cross River State?
- What are the strategies used for management of preeclampsia among midwives?
- What are the outcomes of preeclampsia management among midwives?
- What is the level of knowledge of midwives on eclampsia?
- What is the knowledge, perception and management of eclampsia among midwives in Secondary Health Care Facilities?
1.6 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant association between management and outcomes of eclampsia among midwivies in Northern Cross River State
- H1: There is a significant association between management and outcomes of eclampsia among midwivies in Northern Cross River State
Hypothesis Two
- H0: There would not be a significant association between knowledge of eclampsia and midwives years of service.
- H1: There would be a significant association between knowledge of eclampsia and midwives years of service.
1.7 Significance of Study
This study will be of immense benefit to Midwives, Nurses and other researchers who intend to know more on this study and can also be used by non-researchers to build more on their research work. This study contributes to knowledge and could serve as a guide for other study.
1.8 Scope of Study
The scope of the research is focused on the Assessment of Eclampsia Management amongst Midwives in Secondary Health Care Facilities in Northern Cross River State.
1.9 Limitations of the Study
During the course of this study, many things militated against its completion, some of which are:
- Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
- Research material: availability of research material is a major setback to the scope of the study.
- Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
- Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).
1.10 Operational Definition of Terms
Attitude: The way one behaves towards somebody or something that shows how you think or feel.
Knowledge: To have information about something because you have experience or because you have learned it or be told.
