Abstract

Background: Pregnancy-Induced Hypertension (PIH) is a high-risk condition which implies a threat to pregnancy, either by means of the mother’s health or the health of the fetus. In PIH, the underlying basic pathology is endothelial dysfunction and intense vasospasm affecting almost all the vessels, particularly those of uterus, kidney, placental bed, and brain result the symptoms called vascular symptoms. Thus, PIH affects QOL of pregnant women and perinatal outcome.

Objectives: The aim of this study was to assess the effect of Vascular Symptom Management Package (VSMP) on vascular symptoms, QOL of pregnant women with PIH & perinatal outcome.

Materials and Methods: Quantitative approach with true experimental design was adopted. Ten pregnant women with PIH were selected for the study using purposive sampling technique. Subjects were randomly assigned to the experimental and control group using Sequentially Numbered, Opaque Sealed Envelopes (SNOSE) (5 in the experimental group and 5 in the control group). VSMP includes two sessions: 1-Instructions on strategies to manage each vascular symptoms, fetal well-being assessment, sleep health behavior education, warning signs of complications, and importance of compliance to interventions. 2- Demonstration on Systematic muscle relaxation techniques, Diaphramatic breathing and muscle stretching exercises. The tools used to collect the data were as follows: (1) Demographic questionnaire, (2) vascular symptom assessment scale, (3) Women’s Health Initiative Insomnia Rating Scale (WHIIRS), (4) Edinburg Postnatal Depression Scale (EPDS), (5) WHOQOL–BREF, and (6) perinatal outcome questionnaire. Informed written consent was taken from each participant. Baseline assessment was done on the 1st day and the first session of intervention was implemented on the same day. The second session of intervention was implemented after 1 week. Post-assessment was done after 4 weeks. Mothers were followed till immediate puerperium and perinatal outcome was assessed. Phone calls & weekly meeting were done to make the mother to adhere in practice. The data analyzed using descriptive and inferential statistics.

Results: The post-test mean rank of vascular symptoms of the experimental group was lower (P ≤ 0.05) than that of the control group. The mean post-QOL score of the experimental groups was higher (P ≤ 0.05) than that of mean post-QOL score of the control group. The mean rank of all parameters of perinatal outcome in the experimental group was lower (P ≤ 0.05) than that of the control group. Hence, it can be interpreted that VSMP is effective to improve the reduce the vascular symptoms, improve the QOL & perinatal outcome.

Conclusion: PIH is a life-threatening condition. The findings of this study show that the effectiveness of VSMP improves the QOL. Hence, VSMP is a nurse-led intervention which can be implemented to effectively reduce the vascular symptoms and improve the QOL of pregnant women with PIH.

Key words: Pregnancy Induced Hypertension; Quality of Life; Vascular Symptom Management Package