Date of Award

1-2023

Degree Type

Thesis

Degree Name

Master of Science in Advanced Practice Nurs​ing (MSc-APN)​

First Advisor

Dr Abedinego Ongeso

Second Advisor

Dr Gladys Mbuthia

Department

School of Nursing and Midwifery, East Africa

Abstract

Worldwide, maternal morbidity and mortality among pregnant women pose a major challenge which is mainly brought by hypertensive disorders in pregnancy. Progression of gestational hypertension to severe preeclampsia contribute a lot in adverse birth outcomes hence posing a great challenge especially in developing countries. The study seeks to determine the factors leading to progression of gestational hypertension to severe preeclampsia by checking the sociodemographic factors, maternal obstetrical factors, medical factors and adverse birth outcomes. The study used descriptive cross-sectional design, including all mothers who had a diagnosis of gestational hypertension, pre-eclampsia and eclampsia and delivered in Machakos level 5 hospital. For the study, 251 women in total were consecutively chosen. Closed-ended questionnaires were administered. Data were imported into SPSS after manual completion checks on the questionnaires. Means, proportions, and percentages, standard deviation, frequency distributions, and simple contingency tables were used to summarize and analyze the data on the major variables. Chi square tests and other inferential statistics were employed to demonstrate the relationship between the variables. Tables and graphs were then used to present the data. The School of Nursing and Midwifery Departmental Research Committee reviewed the study and ethical approval sought from the Aga Khan University Ethics Review Committee and Machakos County Hospital Ethics review board. A research permit was obtained from National Commission for Science Technology and Innovation. Results: The prevalence of progression to preeclampsia/eclampsia from gestation hypertension was 67.7% (95%CI: 61.6%-73.5%). The prevalence was higher among women aged 31-40 years (P< 0.001), married, and staying in urban areas compared to their counterparts. Major contributing factors to progression of the disease was advanced maternal age (31-40), non-compliance of hypertensive drugs 118 (47.7%), history of previous gestational hypertension 62(24.7%) with P< 0.001 and poor antenatal care visit attendance 227 (90.4%). Some of the adverse maternal outcomes noted were prematurity, birth asphyxia, intra-uterine growth retardation and stillbirths. In conclusion, preeclampsia remains to be an alarming issue among pregnant women and therefore hospital-based programs should be initiated to create awareness on importance of seeking antenatal services early to curb complications. In addition, safe motherhood initiatives (hypertensive diseases in pregnancy) are recommended in maternity departments to curb the problem.

First Page

1

Last Page

99

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