A survey of the implementation of the national guidelines for the management of pregnancy induced hypertension by midwives at level-1 clinics in the Eastern Cape
Pregnancy induced hypertension (PIH) occurring during pregnancy, labour and puerperium is a major contributor to the high percentage of maternal morbidity and mortality in the Eastern Cape Province, and worldwide. In South Africa (SA), PIH is the second most common of all primary causes of maternal mortality reported in the triennium from 1999 to 2001. From 1999 to 2001, PIH was the cause of 20,7 % (n = 507) of all maternal mortalities in SA (Department of Health (DOH), 2001:38). In the light of these statistics and other statistics related to other causes of MMR, the National Confidential Committee on Enquiries into Maternal Deaths (NCCEMD) developed the National Guidelines for Maternity Care in South Africa, a Manual for Clinics, Community Health Centres and District Hospitals. The guidelines related to PIH were of particular interest in this study. A quantitative, descriptive and contextual survey was conducted to determine the implementation of the National Guidelines for Maternity Care for the management of PIH by the midwife at level-1 clinics in the Eastern Cape, and to make recommendations for the management of PIH by midwives at level-1 clinics with the intention of reducing maternal mortality and morbidity due to PIH. The research method comprised a retrospective record review of the records of all patients admitted with PIH at a level-3 hospital who were referred by a midwife from a level-1 clinic. Data were collected by means of a researcher-administered data collection tool based on the iii National Guidelines for Maternity Care in SA for the management of PIH. The researcher wished to determine whether the National Guidelines for Maternity Care in SA was being implemented for the management of PIH by midwives at level-1 clinics in East London. A purposive sample of 290 maternal records of mothers who had been admitted for PIH at level 3 after being referred from level-1 clinics from May 1999 to June 2003 were used. Data were analysed using descriptive statistics. Ethical issues were taken into consideration. Validity and reliability were ensured. In conclusion, given the study findings, the researcher has made recommendations with the intention of reducing mortality due to PHI in the Eastern Cape.
MSc (Nursing), Faculty of Health Sciences, University of the Witwatersrand, 2009
high blood pressure, hypertension, pregnancy induced hypertension