ABSTRACT
This research work focused on the prevalence of pregnancy
induced hypertension among pregnant women attending Basic Health Centre,
Oke-Aro in Akure South Local Government Area of Ondo State. Descriptive
study design was use, Data were gathered using structure questionnaire, oral
interview and review of existing records. The findings showed that the
expectant mothers attending Basic Health Center Oke –Aro are well informed
about pregnancy induced hypertension, it’s causes complications, and how to
prevent it. The study further revealed that there is a slight increase in the
prevalence of pregnancy induced hypertension in the study area as show by the
review of existing record between January 2019-December 2021 from 5% to 5.2%. Recommendation
we are made to the government on continuous enlightenment about pregnancy
induced hypertension through available media and free medical service to
pregnant women. To health workers on the need to continuously health educate
the expectant mothers et every opportunity intimating them with the cause(s),
sign and symptom prevention of pregnancy induced hypertension and the expectant
mothers on the part should come early for registrations in the facility, keep
antenatal appointment, adhere to medical advice and reporting early at the
facility when the need arises.
TABLE
OF CONTENTS
Title Page
Title page i
Certification ii
Dedication iii
Acknowledge
iv-v
Abstract
vi
Table of contents
vii-viii
List of tables
ix
CHAPTER ONE
Introduction 1
Background of the study 2-3
Statement of the problem 3
Aim of the study 3
Objective of the study 3
Significant of the study 3
Assumptions 4
Definition of terms 4-5
CHAPTER TWO
Literature
review 6-7
Types
of hypertensions 7-11
Risk
factors hypertension 11-12
Complications
of hypertension 12
Physiological
changes in pregnancy 12-13
Normal
physiological change in blood pressure during pregnancy. 13-16
Group
of women at risk of gestational hypertension 16-17
Sign
and symptoms 17
Complications
of PIH 17-18
Pathogenesis 18
Prevention,
management and/ or treatment of pregnancy induced hypertension18-20
CHAPTER THREE
Research methodology 21
Study
design 21
Study
area 21-22
Sample
size 22
Sample
technique 22
Data
collection methods 22
Ethical
consideration 23
CHAPTER FOUR
Data presentation and analysis
24-33
CHAPTER FIVE
Discussion, conclusion and
recommendation
Discussion of findings 34-35
Conclusion 35-36
Recommendation 36
Limitations 36
REFERENCE 37-39
APPENDIX 40
LIST OF TABLES
Table 1: Age distribution of the
respondents 24
Table 2: Marital status of the respondents 25
Table 3: Religion of the respondents 25
Table 4: Occupation of the respondents 26
Table 5: Educational status of the
respondents 26
Table 6: Respondents awareness of
pregnancy induced hypertension 27
Table 7: Respondents opinion on the meaning
of pregnancy induced hypertension27
Table 8: Knowledge of pregnancy induced
hypertension complications 28
Table 9: Causes of pregnancy induced
hypertension 28-29
Table 10: Knowledge of respondents on
signs and symptom of pregnancy induced hypertension 29
Table 11: Whether respondents are aware
that there are associated complications of pregnancy induced hypertension 29-30
Table 12: Idea place of delivery for
pregnancy induced hypertension clients 30
Table 13: Whether pregnancy induced
hypertension can be prevented 31
Table 14: Way by which pregnancy induced
hypertension can be prevented 31
Table 15: Oral interview (for non-literate
respondents) 32-33
Table 16: Review of existing records
between year January 2019- December 2021 (culled from ANC register basic health
centre Oke-Aro) 33
CHAPTER
ONE
INTRODUCTION
Gestational Hypertension
or Pregnancy Induced Hypertension (PIH) is the development of an increase in a
pregnant woman blood pressure after 20weeks of gestation without presence of
protein in the urine or other signs of pre-eclampsia (WHO, 2011). Pregnancy
Induced Hypertension is a major pregnancy complication associated with
premature delivery, Intrauterine Growth Retardation (IUGR), abruption placentae
and intrauterine death as well as maternal mortality and morbidity.
Approximately, 30% of all
hypertensive disorders in pregnancy are caused by gestational hypertension. In
Africa and Asia, nearly one of tenth of all maternal death are associated with
disorders of pregnancy. Whereas one quarter of maternal deaths in Latin America
have been associated with these complications. Among hypertensive disorders
that complicate pregnancy, pre-eclampsia and eclampsia stand out as major cause
of maternal and prenatal mortality and morbidity. The majority of the deaths
due to pre-eclampsia and eclampsia are avoided through the provision of timely
and effective care of the women presenting the complications.
Optimizing health care to
prevent and treat women with hypertensive disorders is necessary step toward
achieving the 8 Millennium Development goals which is now have been changed to
17 Sustainable Developmental Goals, WHO have developed the present
evidence-informed recommendations with a view promoting the best possible
clinical practices for management of pre-eclampsia and eclampsia (WHO, 2011).
BACKGROUND OF THE STUDY
Pregnancy Induced
Hypertension is one of the most common causes of both maternal and neonatal
morbidity affecting about 5-8% of the pregnant women. It is associated with
adverse pregnancy outcomes as well as maternal mortality and morbidity
Worldwide, 10% of pregnant women are affected with hypertensive disorders of
pregnancy. This group of diseases and conditions including pre-eclampsia and
eclampsia, gestational hypertension and chronic hypertension. It is an important
cause of feto-maternal morbidity and mortality (Granger et al, 2001). In
Asia and Africa, nearly one tenth of all maternal death are associated with
hypertensive disorder of pregnancy, where as one quarter of all maternal death
in Latin America have been associated with these complications.
The majority of deaths
related to hypertensive disorders can be avoided by providing timely and
effective care to women presenting the complications. Thus, optimization of health
care for women during pregnancy is necessary step toward achieving of the
MDG'S, now SDG'S (WHO, 2011). In nearly all high income countries, widespread
diagnosis and treatment with low-cost medication have led to a significant drop
in the proportion of people with raised blood pressure across populations and
this has contributed to a reduction in deaths from heart diseases, for example,
the prevalence of raised blood pressure in the WHO region of the Americans in
2014 was compared to 31% in 1980.
In Nigeria, it is
approximated that 11% of pregnancies are complicated by hypertensive disorders
of pregnancy, in which is one of the leading cause of maternal mortality
(Adesokan, 20117). In contrast, low-income countries have the highest
prevalence of raised blood pressure. In the WHO Africa region, more than 30% of
adults in many countries are estimated to have high blood pressure and this
proportion is increasing. Furthermore, the average blood pressure level in this
region are much higher than the global averages (WHO, 2018).
STATEMENT OF THE PROBLEM
It was observed during my rural-urban
practical posting to Basic Health Centre Oke-Aro, that few out of not too many
pregnant women were diagnosed with pregnancy induced hypertension. Therefore,
there is need to investigate its prevalence so that drastic efforts can be made
to control it and prevents its complications.
OBJECTIVES OF THE STUDY
1. To determine the prevalence of
pregnancy induced hypertension among antenatal care clients attending BHC,
Oke-Aro
2. To identify the probable risk factors
associated with pregnancy induced hypertension in the study group.
3. To educate the pregnant women on the
importance of early antenatal registration, keeping antenatal appointments and
having skilled birth attendance.
SIGNIFICANCE OF THE STUDY
The study is set to ascertain the
prevalence of pregnancy induced hypertension among pregnant women in Oke-Aro,
it will also look into the factors that may be responsible for the prevalence,
also the pregnant mothers will be educated on unborn foetus, it will also be
used in creating more awareness on the importance of early antenatal
registration, keeping antennal appointment and skilled birth attendance.
ASSUMPTIONS
1. Some pregnant women believes that
pregnancy induced hypertension is caused by their wicked rivals and the evil
eyes,
2. Some assumes that it is a sign of twin
pregnancy
3. Women in Oke-Aro believes that
pregnancy induced hypertension does not have any complications, and it will
stop before delivery.
4. It is believed that pregnancy induced
hypertension does not associate with pregnancy.
DEFINITION OF TERMS
1. Prevalence: The total number of people
in a population who have the disease (both new and old cases) at a given time.
2. Sign: Is an abnormality seen or
measured by people order than the patient.
3. Symptom: Is an abnormality seen or
detected by the patient.
4. Antenatal care: Refer to the health
care attention, education, supervision, health monitoring and treatment given
to the pregnant women from the time of conception confirmation to the
commencement of labor to ensure safe pregnancy labor and delivery.
5. Proteinurea: Excessive protein in
urine.
6. Hypertension: Is a chronic medical
condition in which blood pressure in the artery is elevated.
7. Induced: To bring something about.
8. Pre-clampsia: is the presence of high
blood pressure after 20 weeks of gestation with the presence of proteinurea in
a woman that has normal blood pressure.
9. Eclampsia: Is the term used for series
of fits or convulsion attacks that occur as a result of pregnancy induced
hypertension.
10. Pregnancy: Is the progressive stage
from conception to birth.
11. Mortality: The death rate of the
population.
12. Morbidity: The incidence of a disease,
as a rate of population which is affected.
13. Pregnancy Induced Hypertension: Is a
high blood pressure developing after 20weeks of pregnancy in a previous
nor-motensive nor-proteinuric women.
14. Complication: A secondary disease or
negative reaction occurring during the course of an illness or a state of
aggravation or deterioration
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