A Descriptive Study to Asses on Knowledge regarding selected Warning Signs in Pregnancy among Primigravida women Attending Antenatal Outpatient Department at selected Hospital, Ahmedabad, Gujarat

Lissy John¹, Seema Thomas², Ganesh Twinkle Rameshbhai³, Kirit Aastha Ashish³,

Patel Aayushi Sachinkumar³, Patel Bansari Swarupkumar³, Patel Kruti Ketan³,

Tailor Jessica Jayantbhai³

¹Principal, Khyati College of Nursing, Plodia, Ahmedabad, Gujarat, India.

²Assistant Professor, Khyati College of Nursing, Ahmedabad, Gujarat, India.

³Fourth Year B.Sc Nursing Students, Khyati College of Nursing, Ahmedabad, Gujarat, India.

*Corresponding Author E-mail: seemabinus2010@gmail.com

ABSTRACT:

Pregnancy and childbirth are special events in woman’s lives and indeed in the lives of their families. Knowledge of obstetric warning signs among pregnant women is of paramount importance in improving maternal and fetal health outcomes. This study aimed to determine the knowledge on warning signs among primigravida women. Descriptive exploratory research design was adopted and using nonprobability convenient sampling 100 primigravida women attending antenatal outpatient department of VS Hospital were selected. The data was collected by administering structured questionnaire and interpreted using descriptive statistical method. Highest percentage (34%) of women belonged to 23-25 years of age, 31% from 20-22 years, 25% from 26-28years and10% from 29-30 years. Majority (56%) of primigravida women had poor knowledge, 40% had average knowledge and only 4% of primigravida women had good knowledge regarding warning signs in pregnancy. Significant association of the knowledge score was found with age, area of residence, level of education, duration of marriage, occupation and monthly income. The study findings indicate that the knowledge of the antenatal mothers regarding warning signs in pregnancy was poor. Thus, the present study highlights the need to take extra effort by the nurses to provide knowledge and awareness that would prevent warning signs in pregnancy among antenatal women. Method: The research design used for study was descriptive exploratory research design. A sample of 100 primigravida women was selected by non-probability convenience sampling technique. The study was conducted in antenatal outpatient department of V.S Hospital Ahmedabad from 19/11/2019-27/11/2019. The data was collected from 100 primigravida women using structured questionnaire. The data collected was analyzed to achieve the objectives of the study and to test the research hypotheses using descriptive analysis. Result: In the study, among 100 primigravida women majority 34(34%) of primigravida women belonged to 23-25 years of age, 53(53%) of primigravida women belong to urban area of residence, 54(54%) of primigravida women had non formal education., 41(41%) of primigravida women had marriage duration below 1 year, 62(62%) of primigravida women were from joint family, 85(85%) of the primigravida women were housewives, 37(37%) of primigravida women had family income per month between Rs.5001-10,000, 45(45%) of primigravida women were between 7-9 weeks of pregnancy, 90% primigravida women had no previous knowledge regarding warning signs in pregnancy and 50(50%) of primigravida women had source of information through family members. The study revealed that 56 (56%) of the primigravida women had poor knowledge, 40(40%) had average knowledge, and 4(4%) of the women had good knowledge regarding the selected warning signs in pregnancy. There was significant association between level of knowledge regarding warning signs in primigravida women with age, area of residence, level of education, marriage duration, occupation and monthly family income at 0.05 level of significance. Non significant association was found with type of family and weeks of pregnancy. Interpretation and Conclusion: The findings of the study proved that the majority of primigravida women had poor knowledge regarding the selected warning signs in pregnancy. Thus the study showed that there is great need to educate primigravida women regarding warning signs in pregnancy and its prevention.

KEYWORDS: Knowledge, Obstetric, Primigravida, Warning Signs, Antenatal women.

INTRODUCTION:

Pregnancy is a period when women’s bodies go through serious physiological changes which may be entirely normal throughout pregnancy, childbirth, and postpartum period. However, this normal process may sometimes be overcome by serious complications which may affect the life of mothers and newborns contributing to maternal mortality and morbidity to the highest level.

A warning sign is a type of sign which indicates a potential hazard, obstacle or condition recurring special attention.¹A Pregnant women may face sudden unpredictable complication that could end her life or injury to herself or to her family. Complication during pregnancy and childbirth are the leading causes of death and disability among women of reproductive age worldwide.²In 2016, complications of pregnancy and childbirth resulted globally in 230,600 deaths, down from 377,000 deaths in 1990.³

In 2013, about 2, 89, 000 women across the world were reported to have died from pregnancy and childbirth related complication.⁴About 700 women die each year from complication of pregnancy. India accounted for about 31% of all maternal deaths worldwide. The maternal mortality rate in Gujarat is 460 per 1, 00,000 live births. Important contributing causes are anemia, poverty, ignorance, malnutrition; inter current infections, hemoglobin patsies. Hemorrhage (24.6%) ranks first as sepsis (13%) toxemia of pregnancy (11.9%), abortions (8%), obstructed labor (6.2%), while other causes together 35.3%.⁴ India has very high maternal mortality rate. It was 20 per 1000 births. Present maternal mortality rate for India was 407 per 1,00,000 live births. Therefore, more than 1,00,000 women die each year due to pregnancy related causes.

It is due to large number of deliveries conducted at home by untrained persons, lack of adequate referral facilities to provide emergency obstetric care for complicated cases and contribute to high maternal morbidity and mortality.The commonest danger signs during pregnancy include vaginal bleeding, edema, headache, reduced fetal movement, abdominal pain, fever, convulsion, breathing difficulty and weakness.⁵

OBJECTIVES:

1. To assess the level of knowledge on selected warning signs in pregnancy among primigravida women.

2. To determine the association between knowledge score on warning signs in pregnancy among primigravida women with selected socio demographic variables.

DELIMITATION:

1. Primigravida women attending antenatal outpatient department at VS Hospital, Ahmedabad.

2. The study is limited to100 primigravida women.

3. The study is limited to primigravida women between 20 to 30 years.

LIMITATION:

1. The study was limited to the period of two weeks.

2. The study was limited to primigarvida women attending outpatient department of V.S Hospital

3. The study was limited to selected warning signs in pregnancy.

ASSUMPTION:

The investigator assumes that:-

1. Primigravida women may have inadequate knowledge regarding warning signs in pregnancy.

2. Pregnant women are susceptible to experience warning signs during the period of pregnancy.

RESEARCH METHODOLOGY:

Research Approach:

In this present study, the researcher aims to assess on knowledge regarding selected warning signs in pregnancy among primigravida women, by using the quantitative research approach.

Research Design:

Research design adopted for the study is descriptive exploratory research design. This research design was used to assess the level of knowledge regarding selected warning sign in pregnancy among primigravida women.

Variables under Study:

Research Variables:

In this study the research variable is knowledge on selected warning signs in pregnancy.

Demographic Variables:

In this study, the demographic variables are age in years, place of residence, education status, duration of marriage, type of family, occupation, monthly family income, weeks of pregnancy and previous information regarding warning signs in pregnancy.

Setting:

Setting for the study is the antenatal outpatient department at V.S Hospital, Ahmedabad, Gujarat.

Population:

In the present study, the target population consists of primigravida women and the accessible population are the primigravida women attending the antenatal outpatient department of V.S Hospital, Ahmedabad, Gujarat.

Sample:

In the present study, the sample consists of 100 primigravida women between 20 to 30 years of age attending outpatient department of V.S Hospital, Ahmedabad.

Sampling Technique

“In this present study, nonprobability convenience sampling was adopted and 100 primigravida women sample were selected.

Criteria for Sample Selection:

Inclusive Criteria:

1. Primigravida women who belong to age group between 20 to 30 years

2. Primigravida women who are in their first trimester (12 weeks) of pregnancy.

3. Primigravida women who are attending antenatal outpatient department of V.S Hospital, Ahmedabad.

Exclusive Criteria:

1. Primigravida women who cannot read and understand Gujarati and Hindi

2. Primigravida women who are not willing to participate in the study.

3. Primigravida who are not available at the time of data collection

Description of the Tool:

Section A:

It consists of 10 items to collect data regarding personal and baseline characteristics of the subjects. It consists of items for obtaining information about the selected demographic variables such as age, residence, education status, duration of marriage, type of family, occupation, monthly family income, weeks of pregnancy, previous information and its source.

Section B:

Structured questionnaire to assess on knowledge regarding selected warning signs among primigravida women which consisted of 20 multiple choice questions. The total score is 20. Each correct response carries “one score” and “zero” for incorrect response. The questions were prepared in Hindi and Gujarati language.

The level of knowledge was arbitrarily categorized as follows:

Good: Above >14

Average: (8-14)

Poor: (0-7)

Data Analysis:

Organization of Findings:

Section I: Frequency and percentage distribution of demographic variables

Section II: Overall knowledge of the primigravida women on level of knowledge regarding selected warning signs in pregnancy.

Section III: Association of level of knowledge regarding selected warning signs in pregnancy with selected demographic variables.

Section- I:

Frequency and percentage distribution of demographic variables

Table 1: Frequency and percentage distribution of respondents according to age

		Frequency (f)	Percentage (%)
1	Age in Years
	a. 20-22years	31	31%
	b. 23-25 years	34	34%
	c. 26-28 years	25	25%
	d. 29-30 years	10	10%
2	Residence
	a. Rural	47	47%
	b. Urban	53	53%
3	Level of Education
	a. Non formal Education	54	54%
	b. Primary Education	43	43%
	c. Higher Secondary Education	3	3%
4	Marriage duration
	a. <1 year	41	41%
	b. 2-3 years	38	38%
	c. >3 years	21	21%
5	Type of family
	a. Joint family	62	62%
	b. Nuclear family	38	38%
6	Occupation
	a. Housewife	85	85%
	b. Government employee	8	8%
	c. Private sector employee	7	7%
7	Monthly family income (in Rs)
	a. <5000	24	24%
	b. 5001-10,000	37	37%
	c. 10,001-15,000	28	28%
	d. >15001	11	11%
8	Weeks of pregnancy
	a. <6 weeks	28	28%
	b. 7-9 weeks	45	45%
	c. 10-12 weeks	27	27%
9	Previous Information
	a. Yes	10	10%
	b. No	90	90%
10	Sources of information
	a. Family members	5	50%
	b. Friends	4	40%
	c. Health workers	1	10%

Section-II

Figure 1: Bar diagram representing the distribution of overall knowledge of the Primigravida women

The bar diagram explain that most (56%) of the Primigravida women had poor knowledge, 40% had average knowledge, and 4% of the women had good knowledge regarding the selected warning signs in pregnancy.

Section- III:

Association of level of knowledge regarding selected warning signs in pregnancy with selected demographic variables.

Table 2: Chi square test result showing association between the knowledge scores with selected demographic variables

		Knowledge			Total	Chi Square	DF	Table Value
		Average (8-14)	Good (>14)	Poor (0-7)	Total	Chi Square	DF	Table Value
Age	20-22years	14	1	16	31	2.995	6	0.81
	23-25 years	15	2	17	34
	26-28 years	7	1	17	25
	29-30 years	4	0	6	10
Residence	Rural	16	3	31	50	3.243	2	0.198
Residence	Urban	24	1	25	50	3.243	2	0.198
Level of Education	No formal education	21	3	30	54	1.613	4	0.807
	Primary education	17	1	25	43
	Higher secondary education	2	0	1	3
Marriage duration	<1 year	16	1	27	44	5.047	4	0.282
	2-3 years	14	3	22	39
	>3 years	10	0	7	17
Type of family	Joint family	25	3	34	62	0.33	2	0.848
Type of family	Nuclear family	15	1	22	38	0.33	2	0.848
Occupation	Housewife	35	3	47	85	2.559	4	0.634
	Government employee	3	0	5	8
	Private sector employee	2	1	4	7
Monthly family income	<5000	10	1	13	24	3.437	6	0.752
	5001-10,000	14	3	20	37
	10,001-15,000	12	0	16	28
	>15001	4	0	7	11
Weeks of pregnancy	<6 weeks	10	1	17	28	0.805	4	0.938
	7-9 weeks	20	2	23	45
	10-12 weeks	10	1	16	27