CHAPTER ONE
1.0.INTRODUCTION
1.1.BACKGROUND OF STUDY
Women go through a variety of physiological changes during pregnancy.
Changes in the blood circulatory system are particularly notable, permitting normal fetal growth. Even in normal pregnant women, the hemoglobin concentration decreases with dilution following an increase in the volume of circulating blood. About 20% of pregnant women suffer anemia, and most of its (WBCs) fight infection. They are part of the body’s immune system. In the body there are five different types of WBCs. When there is an infection or other type of illness, the body will make more of the specific type of WBC that is needed to fight that illness. Platelets are tiny oval-shaped blood cell fragments that help in blood clot. If one begin to bleed inside or on the surface of the body, platelets gather at the spot and stick together to seal small cuts or breaks on the blood vessel walls. Then, proteins called clotting factors join the platelets to form a stable clot that stops the bleeding.
Pregnancy, also known as gravidity (a Latin word for heavy) or gestation is the time during which one or more offspring develops inside a woman (Pregnancy: Condition Information, 2013). A pregnant female is sometimes referred to as a gravid (The Free Dictionary, 2008). Also the term parity (abbreviated as “para”) is used for the number of times a female carries a pregnancy past 20 weeks of gestation. A woman who has never been pregnant is referred to as nulligravida. A woman who is or has been only pregnant for the first time is referred to as primigravida (Robinson and Victor, 1939), and a woman in subsequent pregnancies are referred as a multigravida or multiparous (Merriam-Webster, 2012).Therefore, during a second pregnancy a woman would be described as gravida 2, para 1 and upon delivery as gravida 2, para 2. Pregnancy can occur by sexual intercourse or assisted reproductive technology.
Childbirth typically occurs around 40 weeks from the last menstrual period (LMP) (Abman, 2011). This is just over nine months, where each month is about 29½ days (Abman, 2011). It’s about 38 weeks when measured from conception. Term pregnancy is 37-41 weeks, with early term being 37 and 38 weeks, full term 39 and 40 weeks and late term 41 weeks. After 41weeks, it is known as post term and before 37 weeks it is known as pre term (Pregnancy: Condition Information, 2013). Pregnancy can be divided into three trimesters according to types, each of about three months (Collins English Dictionary, 2012).
. Women’s health is central to the survival of the society as they give beginning to the new life on the earth and cares for all the family members.Both developed and developing countries are affected by anemia. It has been a global public health problem with major consequences for human health. It affects people of all age groups but its prevalence is more in pregnant women and young children. According to WHO, anemia is classified as mild degree (Hb 9.0-11.0 g\dl), moderate ( 7.0-9.0 g\dl) and severe ( 4.0-7.0 g\dl). (World Health Organization (WHO), 2012).
1.2. STATEMENT OF PROBLEM.
Anemia affect both developed and developing countries. In developing countries, the major cause of anemia is hookworm infestation because many developing countries are located in tropical climate. The WHO has estimated that the prevalence of anemia ranges from 40-60% in the developing countries. Half of those who are suffering from anemia are supposed to be suffering from iron deficiency anemia (IDA). The WHO has estimated that the prevalence of anemia in developed and developing countries in pregnant women is 14% in developed countries and 51% in developing countries. The prevance of anemia is very high. I.e (37-75%) in developing countries to that of 15% in developed countries.In view of these development, the researcher developed an interest in the investigation on knowledge of the causes and prevention of anemia among pregnant women.
1.3 RESEARCHQUESTIONS.
-What are the causes of anemia during pregnancy?
-What are the preventive measures of anemia during pregnancy.
1.4. AIM OF STUDY.
The aim of study is to determine the various causes of anemia during pregnancy and to identify ways whereby it can be prevented among pregnant women in Ukpenu in Ekpoma community.
1.4.1 OBJECTIVES.
-To determine the various causes of anemia in pregnancy.
-To determine how anemia can be prevented during pregnancy.
1.5. SIGNIFICANCE OF STUDY.
- This study will help to improve the knowledge of ukpenu community on the causes of anemia during pregnancy.
- It will also enlighten the community especially the pregnant women and to be mothers on ways to avoid/prevent anemia during pregnancy.
- It will increase the knowledge of the nursing student and on the advocacy on prevention of anemia during pregnancy.
1.6. SCOPE OF STUDY.
The study is been carried out in Ukpenu health centre in esan west local government area, Ekpoma, Edo state.
1.7. OPERATIONAL DEFINITION OF TERMS
ANEMIA: Anemia can be defined as a reduction in the hemoglobin, hematocrit or red cell number. In physiologic terms an anemia is any disorder in which the patient suffers from tissue hypoxia due to decreased oxygen carrying capacity of the blood. Anemia is a state which exists when the hemoglobin is less than 12 g/dL or the hematocrit is less than 37 cL/L.
PREGNANCY: The state of carrying a developing embryo or fetus within the female body which can be indicated by positive results on urine test, and confirmed through a blood test, ultrasound, detection of fetal heartbeat, or an X-ray. It lasts for about nine months, measured from the date of the woman’s last menstrual period (LMP). It is conventionally divided into three trimesters, each roughly three months long.
ANEMIA IN PREGNANCY
Anemia in pregnancy is defined as a hemoglobin (the molecule which carries oxygen in the blood) concentration of less than 10 gm/dl. in which a patient with a hemoglobin of less than 11 gm/dl to 11.5 gm/dl at the start of pregnancy is considered as anemic. This is because as the pregnancy progresses, the blood is diluted and the woman becomes anemic.
This dilution of blood in pregnancy is a natural process and starts at approximately the eighth week of pregnancy and progresses until the 32nd to 34th week of pregnancy.
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