Self-Care Practices among Pregnant Women Undergoing Post-Operative Cervical Cerclage

Abstract

Summary P regnancy loss at any stage is distressing especially when this happens later on in the pregnancy.one of the most important causes that lead to this problem is incompetent cervix which defined as inability of uterine cervix to retain pregnancy until term resulting in second or early third trimester delivery (Drakeley, Roberts & Alfirevic, 2014). Cerclage is the use of ligatures around the uterine cervix to treat cervical incompetence during pregnancy. It is usually performed between 12–14 weeks before the cervix has begun to thin or dilate and is removed towards the end of pregnancy (Medical dictionary). Cerclage is a day surgery in which the women discharge after recovery from anesthesia once they are able to ambulate and void. So that postoperative instructions must be given by the nurse aiming to Primary prevention through life style advice that has potential to be effective strategy to reduce post-operative complications and to improve health outcome (Philip, 2015). The present study aimed to assess self-care practices among pregnant women undergoing post-operative cervical cerclage. This attained through fulfilling the following objectives: assess women knowledge about cervical cerclage and assess self-care practices among pregnant women. To achieve the study objective, a descriptive study had been implemented at inpatient units and post-operative room, in central Basyon Hospital located at Tanta city. A purposive sample technique was used and this technique followed for data collection till the completion of the specified period of data collection. Ninety eight women were included in the study that started from July 2015 to April 2016. Two tools were used for data collection; interviewing questionnaire named cervical cerclage Structured Interviewing questionnaire sheet to assess pregnant women knowledge and self-care practices regarding postoperative cervical cerclage, and follow up sheet to assess maternal and fetal health condition during pregnancy and after cerclage removal. The present study revealed that: • About 57.1% of the total sample their age ranged between 20-35 years. It found that the mean age of the study sample was (28.02± 2.11). Also 70.4 % of women were from rural area. In relation to level of education 62.2% were secondary education. Concerning occupation, 87.8% were not occupied. • Regarding to obstetric history of the study sample about 84.7% of studied sample their gravidity were three times or more and 53.1% of them were multipara as regarding their parity. Also this table reveals that all women had pervious abortion and 46.9% of them had abortion 3times or more. In relation to time of cerclage, all women were between 12-14 weeks of gestation. Concerning pervious cerclage, 53.1% of them were have pervious history of cerclage. • Total knowledge of studied sample regarding cerclage and self-care were 83.7 % of studied sample have incorrect answer from total score of knowledge while 16.3% of them have correct answer. • About 92.9% of studied sample their source of information regarding cerclage and self-care was the doctors. • Total practice score of studied sample were 57.1% unsatisfactory self-care practices. • The study revealed that 33.7% of maternal vital signs were abnormal, concerning Types of maternal vital signs abnormalities, 51.5% were tachycardia. While 79.6% of studied sample had health problems. Concerning types of major complains, 66.7% were genital infection. • About 46.9% of the total sample their gestational age at delivery was 37 weeks or more, 77.6% of maternal vital signs were normal, while 53.1% have health problems. Concerning types of health problems, 80.8% were preterm labor. Also the study illustrated that 53.1% of neonatal heart rate was abnormal. While 63.3% of them have health problems. Concerning types of health problems, 67.7% were had respiratory distress syndrome. • There was a highly statistical significant difference between women knowledge regarding cervical cerclage and their place of residence and occupation. • There was a statistical significant difference between women self-care practices regarding postoperative cervical cerclage and their age. While, there is a highly statistical significant difference between self-care practices regarding postoperative cervical cerclage and their educational level. • There was highly statistically significant association between knowledge and self-care practices among the studied sample. • About 53.1%of women who had unsatisfactory self-care practices have health problems with highly statistically significant association between maternal health problems and self-care practices among the studied sample. • On the same line, the study revealed that 32.7 % of women had unsatisfactory self-care practices and gestational age at delivery was 33-36 weeks, while 30.6% of women had satisfactory self-care practices and gestational age at delivery was 37 weeks or more with highly statistically significant association between gestational age at delivery and self-care practices among the studied sample.