PREVALENCE OF HYPERTENSIVE PATIENTS ATTENDING MATERNITY CLINIC

ABSTRACT 
This research set out to assess the prevalence of hypertension among pregnant women attending antenatal care at UUTH. Specific objectives included: determining proportion of pregnant women with hypertension, to assess factors related to hypertension and complications due to hypertension. It was noted that all the respondents in the study population had ever been diagnosed with hypertension or have hypertension. This was attributed to the fact that they were pregnant and pregnancy puts women at a high risk to hypertension and other cardiovascular conditions. The major factor noted to predispose the pregnant women to hypertension was adding extra salt to food. This was blamed on the fact that the respondents did not know the health effects of adding extra salt to already prepared food. This can be addressed by adequate health talks during antenatal care period. Other factors noted to predispose one to hypertension was family linkages/genes, taking alcohol and smoking. Most of the respondents agreed that if hypertension is not treated complications can arise. The major complications that can arise due to unmanaged hypertension according to the respondents were cardiovascular diseases. Other complications that closely followed were pre-eclampsia and eclampsia. This knowledge expressed was expected since most individuals believe hypertension is directly related to the cardiovascular system though they don’t know the exact mechanism of how the two are related. 

CHAPTER ONE 
INTRODUCTION 
1.1.0 Background information 
Hypertension is the presence of a chronic elevation of systemic arterial blood pressure above normal threshold value. WHO defines hypertension as systolic blood pressure of greater than 140mmHg and or diastolic blood pressure greater than 90mm Hg. Hypertension is one of the major risk factors and main cause death in adult populations worldwide, it doubles the risks for cardiovascular diseases like; ischemic heart disease, congestive heart failure, peripheral arterial diseases and stroke (Harrison; 2008). It is also one of the most frequent chronic conditions in medical consultation (Moliere et el., 1998). 

Studies from India and Bangaladesh have shown upward trend in the prevalence of hypertension (World Health Organization; 2001). In Nigeria a study conducted in the Teso showed a prevalence of hypertension above 30%o among adults aged 21-50 years (Williams; 2002). 

More than 95% of patients with elevated blood pressure have essential (idiopathic, primary) hypertension. In the remaining 5 percent of cases, the elevated blood pressure could be due to; kidney disease, Diabetes or another underlying disorder (Brundt ; 2002). 

Hypertension is highly prevalent in Egypt; the levels of awareness, treatment and control are relatively low (Ibrahim et. al; 1995). There had been an increased prevalence of hypertension in rural and urban areas of Tanzania, probably because of low levels of detection, treatment and control (Edwards’s et. al; 2000). High blood pressure has been found to common among the urban poor from Ibadan in Nigeria (17%) and substantially even more prevalent in well off workers in Harare, Zimbabwe (26%) (Cooper et. al; 1997). 

In a study set out to determine the prevalence and symptomatology of hypertension in Khartoum area, the prevalence of hypertension was determined to be 7.5%-10% (Ahemd; 2002). Hypertension in pregnancy is multifactorial disorder, despite insufficient knowledge related to the genetic and environmental mechanism’s involved in its pathogenesis. Much risk has been implicated; environmental factors, increased body weight and smoking are among risk factors for hypertension in pregnancy. Increasing Body mass index is tightly related to the occurrence of mild hypertension, though not with severe form of these disorders and on the other hand in contrast to previous knowledge, smoking seems to reduce the risk of preeclampsia through expression of specific antigenic factors. Epidemiological studies correlated hypertension in pregnancy with socioeconomic data as its prevalence is significantly higher in women of lower socioeconomic level (Bodnoret. al; 2007). 

Women who developed hypertension during pregnancy have a higher risk of chronic kidney disease, their blood pressure, heart and kidney should be monitored after delivery and an estimated 5 percent to 10 percent of pregnancies are affected by hypertensive disorder previous. Pathological findings; fibrin deposits in kidneys, fibrin deposits in liver with necrosis and periportal hemorrhages and placental vascular abnormalities (Caritis, et al; 1998). 

Normally a woman blood pressure drops during her secondary trimester then it returns normally by the end of the pregnancy. But some women blood pressure goes up very high in the second and third trimester this is sometimes called gestational hypertension. Hypertensive women are advisable for regular exercise and regular monitoring the blood Pressure, reduced in dietary intake and salt intake, mothers are preferable to monitor their Blood pressure daily, and antihypertensive drugs will reduce the risk of the disease (Jeyabalanet. al; 2008). 

1.1.1Problem Statement 
959, 00 death worldwide were caused by Hypertension accounting for 1.6 percent of all death and approximately 3% of all death caused by non-communicable disease. 

Hypertension remains increasingly an important cause of mortality and morbidity in both developed and developing Countries, its estimated that in the next decades, hypertension will be a major cause of death than any other familial disease and non-communicable disease. 

Prevalence of hypertensive disorder in pregnancy and associated factors is unknown in Bushenyi District, Nigeria. 

1.1.2 Objectives of the study 
General Objectives: 

To assess the prevalence of hypertension among pregnant mothers attending antenatal care in University of UyoTeaching Hospital. 

Specific Objectives: 

To determine the distribution of mothers presenting with hypertension in pregnancy among those mothers who attended Antenatal care at University of UyoTeaching Hospital. 

To assess the factors associated with the current prevalence of hypertension in pregnancy among pregnant mothers who attended Antenatal care in University of UyoTeaching Hospital. 

To outline the complications resulting from hypertension in pregnancy and suggest possible additional ideas towards improved methods of management. 

1.1.3 Justification of the study 
Hypertension is one of the major risk factors for cardiovascular diseases and the main cause of death in adult Populations worldwide. 

Hypertension in pregnancy is the major causes of 80% of maternal deaths globally, 6% of maternal deaths in Nigeria. Changes in maternal characteristics are a risk factor to increase in HDP. The probability of HDP detection among pregnant women is 0.28 (UDHS, 2011). 

The study will help all parties in patient care to plan and make better interventions that will affect the mother’s awareness towards preventing and early detection plus management of hypertension. 

Finding will be of great importance to future studies for those who may be interested in this area of medical science. 

1.1.4 Research Questions 
What is the prevalence of hypertension among pregnant mothers who attended Antenatal care at University of Uyo Teaching Hospital? 

What are the factors associated with hypertension in pregnant mothers who attended Antenatal care at University of Uyo Teaching Hospital? 

Which complications were due to hypertension among pregnant mothers who attended Antenatal care at University of Uyo Teaching Hospital? 

Which are the possible ways of preventing and controlling hypertension in pregnancy? 

1.1.5 Study scope 
Geographical: University of Uyo Teaching Hospital is located in Uyoakwaibom state. 

Content: Long distances to the health facility, low level of education, poor health seeking behaviors are among the factors that could lead to increased cases of hypertension in pregnancy in third world country settings.

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Item Type: Project Material  |  Attribute: 37 pages  |  Chapters: 1-5
Format: MS Word  |  Price: N3,000  |  Delivery: Within 30Mins.
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