KNOWLEDGE PERCEPTION & ATTITUDE AMONG PREGNANT WOMEN ATTEND ANTENATAL CARE IN PHC ASHAKA JALINGO FUNAKAYE L.G.A GOMBE STATE

CHAPTER ONE
1.0 INTRODUCTION
1.1 BACK GROUND OF THE STUDY
Eclampsia is a disease of the pregnancy characterized by high blood pressure of 140/90mmhg and above after 20 week of the pregnancy accompanied by significant proteinuria (presence of protein in the urine) above 300mmhg in 24hrs (Philip 2006)According to Manish et al (2008) eclampsia can be defined as the convulsion occurring in women with established pre-eclampsia; in the absence of any neurological or metabolic cause.The patient with eclampsia present with convulsion proturia, hypertension and cerebral sings, such as headache, nausea, vomiting, and cortical blindness. Other symptoms include abdominal pain, chest pain, and pulmonary cdema (mike 2005) pre-eclampsia complicates approximately three (3%) percent of the pregnancies but the knowladge varies depending on exact definition used and population studies. eclampsia is relatively rare in developed countries like U.K, occurring like in 1:200/300 pregnanciesworldwide if it is for a greater problem with an estimated 72,000 deaths annually (Philips 2006) in the developing countries there is low utilization of antenatal and intraperatum care and the patient may be present to hospitals only as a last report (chelidhary).The exact course of eclapsia is thought to be commonly in first pregnancy, and young mothers where it is anorel exposure to perintal aantigen involved furthermore, woman with pre-existing vascular disease such as hypertension, diabetes, mellitus, and neuropathy are at risk to develop pre-eclampsia and eclamptic people with such a large placenta (multiple pregnancies hydati form mole) also predisposes a person to this condition (smith 2007) eclamsia contributes significantly maternal and to perinatal morbidity in Nigeria, it is a common cause of maternal mortality worldwide but particularly in the developing countries. It is estimated that every year eclampsia is associated with about 50,000 maternal deaths worldwide, most of which occur in developing countries. A study is carried out in 2004 by society of gynecology and abstetric revealed that eclampsia is a major con tributor to maternal mortality in the whole country, eclapmsia contributes about 46.3% of all maternal deaths (ekele el al, 2007).
1.2. STATEMENT OF THE PROBLEM
Eclampsia is a serious health problem with high maternal mortality rate in Nigeria of which song local government area is among. It is a disease condition that affects pregnant women few and hours to delivery in both developed and developing countries where antenatal care is not adequately or poorly utilized. The researcher intended to carry out the study in other to determine the knowladge and the gravity that this condition mostly affects and the age group mostly affected by eclampsia. The major problem of this condition is that the cause is unknown, hence very difficult to prevent and treat, however factors such as heredity and hypertension are believed to predispose one to have the condition and they are common in our society and this other factors are surrounding, eclampsia are what stimulated research work and with the aim to provide solution for the effective planning of health care delivery system in general hospital PHC Jalingo, Gombe state and the country at large and also contribute to the body of knowledge.
1.3. OBJECTIVE OF THE STUDY
To determine the knowledge of eclampsia among pregnant women attending antenatal clinic in PHC Jalingo Gombe state 2022 October to march 2023. To know the age group mostly affected by eclampsia Knowledge determine the gravity of eclampsia developed by the woman.
1.4. SIGNIFICANCE OF THE STUDY
By the end of this research work knowledge on eclampsia will be added and rate of occurrence within October 2022 - March 2023 as a result of age gravity of eclampsia will be understood. In the area of the study it can also be identified, thus helping in crating awareness and health education to the community and general population. It will also help government in planning program towards reducing and preventing the occurrences of the disease it will also serve as a guide for further research work give idea suggestions and clues on the various pre-disposal of the disease.
1.5. RESEARCH QUESTIONS
What was the knowledge of eclampsia among pregnant women attending antenatal clinic in PHC Jalingo Gombe state from 2022-2023What age group is mostly affected by eclampsiaWhat is the gravity of the condition of woman who developed eclampsia
1.6. SCOPE OF THE STUDY
The research work is limited to pregnant women attending PHC Jalingo Gombe state. This particular group of is targeted because they are the ones who are affected by eclampsia. Time is only major delamination factor encountered to express themselves fully also constitutes a limiting factor towards carrying out this research
1.7 OPERATIONAL DEFINITION OF TERMS
Disease is any disturbance or any abnormally in the normal function of the body that probably has a specific cause and identifiable symptoms. PREGNACY: is a period of conception to birth PROTEINURIA: excessive presence of serum protein in the urine.
CONVULSION: is an involuntary contraction and movement of involuntary muscle.
HYPERTENSION: persistence increase in blood pressure above normal range of 100/90 to 140/90mmhg.
TOXAEMIA: is a condition resulting from metabolic disturbance or poisoning of blood.
NUSEA: a feeling of sickness with an inclination to vomit.
VOMITING: a reflex art of expulsion of stomach content via the esophagus and mouth.
INCIDENCCE: is a rate/number/frequency of occurrence of a particular disease in a particular area.
MORTALITY: is the ration, of death in areas to the population of the area expressed per 1,000 per year.
MATERNAL: pertaining to mothers
PERTERNAL: pertaining to fetus
NEUROPATHY: a disease process of nerve degeneration and loss of function
THRUMBUS: a stationary blood clot caused by coagulation of blood.
ANTENATAL CARE: is a care given to pregnant and her baby starting from the time of conception up to the time of delivery of the baby.
SYNDROME: a group of signs or symptoms typically of distinctive (checks) disease which frequently occur together and from a distinctive clinic picture.
MORBIDITY: is a state of been ill


CHAPTER TWO
2.0. LITERATURE REVIEW
This chapter entails the review of relevant literatures, the information collected from various sources is organized under the following subheadings; in cadence of eclampsia, nature of disease, causes, predisposing factor of eclampsia, pathophysiology, sing and symptoms, eclamptic seizure, diagnosis/ investigation medical and community management of eclampsia and complications.
2.1. KNOWLADGE OF ECLAMPSIA
According to WHO (2007) an estimated 10% of pregnancies are affected by hypertension world-wide approximately one half of all hypertension in pregnancies disorder is due to pre-eclampsia.The pre-eclampsia and eclampsia can see total rate is approximately 6.4 cases per 10,000 cases at delivery (REP) the most significant maternal complication of eclampsia is related to permanent central nervous system (CNS) damaged secondary to the current seizure or intracranial bleeding.The maternal mortality rate is 8.36% in the cases.The federal mortality rate varies from 13-30% due to premature deathin western countries higher mortality rate are associated with patients who have multiple seizure outside the hospital and those without prenatal care (nancy2007) in developing countries like Nigeria, mortality is as high as 14 % and is associated with lack of resource and intensive care facility required for supportive management of pre-eclampsia which complicatesapproximately 3% of pregnancies, but the knowladge varies, depending on exact definitions used and population studies of eclampsia is relatively rate in developed countries like UK, occurring in approximately 1: 2000 pregnancies world-wide; it is far greater problem with an estimated 72,000 death annually (philip2006)
2.2. NATURE OF DISEAESEE
Eclampsia can be defined as an acute life threatening condition characterized by appearance of chronic seizure, usually in a person who had are collectively called people with developed pre-eclampsia and hypertensive disorder (philip2006)According to GABBE (2007) eclampsia in a pregnant woman is a condition that is not related to a pre-existingbrain condition.Moreover Manish (2006) also stated that pre-eclampsia is a multi system disorder characterized by hypertension and proteinuria which generally occur in a second half of pregnancy proceeding pre-eclampsia suggest eclampsia
2.4. CAUSES/ PREDISPOSING FACTORS OF ECLAMPSIA
The etiology (cause) of eclampsia is not fully known. Studies in animal's modes have suggested dys function in the uterroplacenta bed related to alter endothelial cell. Endothelial, angiogenic factor and muscular implantation. This result in decreased ateroplancenta perfusion pressure and is chemia with a subsequent realize of cytokines and reaction of oxygen species. The effect is a sympathetic and nuerohomonal derogation of blood pressure, generalized vasoconstriction and cellular organ system.The other causes may include the following: Altered cardiovascular reactivity: increased capillary permeability, widespread rasospasm, micro thrombi, hypertension and improper implantation of the placenta (mark2008).Predisposing factors of eclampsia in family history of pre-eclampsia (prior eclampsia and eclampsia poor pregnancy (including intrauterine growth, retardation, abruption, placenta or fetal death) pre-existing medical conditions such as obesity, chronic hypertension, renal disease, thrombophilia's, antphespholipid antibody syndrome, protein c deficiency and protein s deficiency, anti-thrombi deficiency, vascular and connective tissue disorders; gestational diabetes and systemic lupus erythromatous.Other predisposing factors of eclampsia include teenage pregnancy, primi gravid and patient older than 35 years and lower socio-economic status (dianne2007)
2.7. SIGNS AND SYMPTOMS OF ECLAMPSIA
Seizure or prostical state (100%)Headache (80%) usually fractaGeneralized oedemaVisual disturbance(40%) such as blurred vision or photophobia Right upper quadrant abdominal pain with nausea (20%)Amnesia or other mental status changes
FINDING A POHYSICAL EXAMINNATION MAY INCLUDE THEFOLLOWING:
Sustained systaltic blood pressure greater than 110MMHGTachypneaTachycardiaMental status changesPapilledemaOliguria or anuriaLocalizing neurological deficitsRight upper quadrant or epigastria tendernessSmall fundal height for the estimated gestational age Apprehensive (mark2008)
THE ECLAMPSIA SEIZURE Chesky (2004), distinguished four stages of an eclampsia event STAGE OF INVASION:- in this stage, facial twisting can be observed around the mouth STAGE OF CONTRACTION:- in this stage tonic contraction renders the body 15 to 50 seconds STAGE OF CONVULSION: - This is a stage at which involuntary and forceful muscular movement occur, the tongue may be bitten, foam appears at the mouth. The patients stops breathing and becomes cyanotic, this stage last about one minute.
FINAL LAST STAGE:- Is more less prolonged comma when the patients awakens she is likely to remember the event in some rare cases there are no conclusion and the patients falls directly into comma. Some patients when they are awake from the comma may have temporary blindness (mark2008).28.
DIAGNOSIS/INVESTIGATION OF ECLAMPSIAI. LABORATORY STUDIES:- laboratory determination is useful in predicting (maternal) or neonatal outcome in women with eclampsia, laboratory studies that should be ordered include the following: complete blood count, blood type and screen urinalysis for proteinuria electrolyte,serum calcium and magnesium, liver function test (i.c. lactate dehydrogenase (LDH) aspartate aminitrasferase (AST) serum glucose etc. the most common hematological abnormality is thrombocytopenia which occur in 17% of patients with eclampsia disseminated intravascular coagulation (DIC) is common in patients with eclampsia.
2. IMAGING STUDIES: - imaging studies may be indicated after initial stabilization especially if there is about the diagnosis or possible injuries secondary to seizure activity. Computed tomography scan of the head with or without contrast can exclude cerebral venous thrombosis intracranial, hemorrhage and central nervous system lesions all of which can occur in pregnancy and present seizures.Characteristics computed tomography findings including critical hypo-dense area particularly in the occipital lobe and diffused cerebral oedema which is believed to correspond to particular hemorrhage and oedema noted in postmortem studies. Magnetic resonance imaging of the head abnormal finding have been reported in up to 90% of woman imagied. Other test include electro- encephalogram (EEG) and cerebral spinal fluid studies (George, 2007).

    Date: 2026-08-11 00:00:00.000000