الفهرس 
I. IntroductionOnly 14 pages are availabe for public view
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Abstract
Pregnancy is a normal physiologic process and a joyful event to the
family. Although at times, some of the common discomforts of pregnancy
may make the pregnant woman feel ill. Problems of pregnancy range
from mild irritating symptoms of nausea and vomiting to life-threatening
conditions (Marshall & Raynor, 2014). Women die from a wide range
of complications related to pregnancy, childbirth or postpartum period.
These life threatening complications are manageable and treatable, so,
most of these deaths are avoidable if women with the complications are
alert and able to identify and seek timely and appropriate emergency
obstetrical care (Oni, et al., 2016). World Health Organization estimated
that 529,000 women die annually from maternal causes. Ninety-nine
percent of these deaths occur in the less developed countries (Hailu, et
al., 2014). Dangerous signs in pregnancy are those signs that a pregnant
woman will see, or feel which indicate that “something is going wrong”
with pregnancy (Royston & Armstrong, 2010).
Perception is defined as “mental process of becoming aware of or
recognizing an idea; primarily cognitive rather than affective or conative”
(Medical dictionary, 2015). Also,perception is defined as “the way of
thinking about or understanding something” )www.Merriam-webster.
com/dictionary/perception). In addition, (Neisser, 2014) defined
perception as “people’s judgments and an evaluation of hazards they (or
their facilities, or environments) are or might be exposed to” Perception is
closely related to attitudes. According to (Lucidi et al., 2010) perception
is” the subjective assessment of the probability of a specified type of
accident happening and how concerned we are with the consequences”
Perception of dangerous signs offers a pregnant woman and her
baby several advantages. First, identification of the dangerous signs
before complications occur can help the pregnant woman prepare and
give the time to seek assistance from skilled attendants, and arrange
transportation to the hospital, Second, perception of dangerous signs will
improve people’s awareness when they need to seek health services
because many dangerous signs do not frighten mothers and their families.
Perception of dangerous signs can increase people’s confidence and
willingness to seek care. Third, dangerous signs can alert people to take
immediate and appropriate actions for preventing and minimizing the
development of complications (Okour, 2012).
There are several causes for having dangerous signs which include
vaginal bleeding as a result of threatening abortion, ante partum
hemorrhage, cervical lesions, leaking of fluid from the vagina as a result
of premature rupture of membranes. Also, abdominal pain as a result of
premature labor, abruption placenta, dizziness, blurring of vision, spots
before the eyes hypertension, pre- eclampsia, fever or chills as a result of
Infection (Okour, 2012).
The factors that influence knowledge and perception of women
towards dangerous signs in pregnancy could be classified into three broad
categories: 1.socio-cultural economic factors such as age, education,
occupation and financial status. 2. Service related factors such as a
distance to health facility, quality of services and availability of
appropriate human resource. 3. Pregnancy related factors such as: Parity,
number of antenatal visits, severity/ type of the dangerous signs
(Thomson, 2011; Amarin, 2012 and Duysburgh et al., 2013).
Dangerous signs of pregnancy include: 1. vaginal bleeding is one
of the biggest dangerous signs during pregnancy, severe headaches which
could be due to high blood pressure from pre-eclampsiaor other causes
like, typhoid fever etc. There may be associated blurring of vision
,pathological edema, Severe abdominal pains due to trauma to the
abdomen, peptic ulcer disease, or antepartum hemorrhages from abruptio-
placentae , Convulsions which could be due to eclampsia, Excessive
Nausea and vomiting usually due to hormones produced/ released during
pregnancy influencing the gastrointestinal tract, Infective vaginal
Discharge and Itching due to sexually transmitted diseases that can have
important consequences in pregnancy , Pain or Burning During Urination
that can be signs of bladder or urinary tract infections, and if left untreated,
they can lead to more serious illness, infection, pre-term labor, and pre-
term birth, pathological edema, Severe Headache which does mean a
greater chance of developing a blood clot. A blood clot in the calf may
lead to pain or swelling and can result in a blood clot that travels to
the lung, which could be fatal &Depression. It is normal to have mood
swings due to all the hormonal changes and could be a dangerous sing
(Kabakyenga et al., 2011; Amarin, 2012 and Fernandes et al., 2014).
The purpose of the current study was to assess perception of
pregnant women toward dangerous signs of pregnancy.
The present study was carried out at antenatal care clinic at
Maternal and Child Health Centers (MCH) at Shebin El-Kom (Qebli),
Menoufia Governorate, Egypt.
Descriptive design was used to assess dangerous signs of
pregnancy perception.
A convenience sample of 253 pregnant women attending Qebli
MCH for antenatal care. Inclusion criteria of study participants were:a)pregnant women, b) their ages ranged from 20- 38 years old. Women had
given birth before, c) free from any disease.
Data was collected using two tools: Tool 1: a self- reported
interview questionnaire developed by the researchers. The questionnaire
contains three parts.
I. First Part 1: socio-demographic data: It included age, educational
level, occupation and income.
Part II: previous history of pregnancy and labor: Parity, number of
children, antenatal visit to the MCH clinic in the previous pregnancy,
gestational age in the first visit.
Part III: current history: as age of gestational, visit to the antenatal
care clinic in the present pregnancy and gestational age in the first visit.
Tool 2: Perception of pregnant women about dangerous signs of
pregnancy: This tool consisted of a questionnaire that was developed by
the researcher after reviewing the tools developed by Nambala (2013)
and Ebrahim et al., (2017), Birukila, (2017) to assess woman’s
perception (knowledge, beliefs and attitude) towards dangerous signs
during pregnancy. This tool consists of the following parts:
Part I: Knowledge about dangerous signs during pregnancy: It
contains questions related to the meaning of dangerous signs of
pregnancy, causes, source of information, the complications that can
occur, the risk factors for developing dangerous signs, previous
experience of dangerous signs in last pregnancy, the importance of
antenatal visit ,danger signs in the first trimester include (Vaginal
bleeding, excessive nausea and vomiting ,infective vaginal discharge ,leg
or calf pain., danger signs in the second trimester include (Dyspnea
,uterine contraction (abdominal pain), headache, danger signs in the third trimester include (Absence of fetal movement ,premature rapture of
membrane , Bleeding ) and action for every danger signs as (Bleeding:-
Home remedy &Immediate asking help from a health center
,Hyperemesis:- call your doctor or may need hospitalization to treat the
dehydration, Infective vaginal discharge: call your doctor as treating it
can relieve pain, and help assure a healthy pregnancy, leg or calf pain
,severe headache:- consult your doctor. Home remedy & Immediate
asking help from a health center).
Part II: Attitude towards prevention of dangerous signs of
pregnancy: It contains 8 statements related to pregnant woman’s
attitude related to prevention, antennal care in the first, second and third
trimester to prevention dangerous signs of pregnancy, importance of
knowledge related to dangerous signs. ..etc
Part III: Beliefs toward dangerous signs of pregnancy:
It contains 7 statements related to the woman’s beliefs about
dangerous signs of pregnancy: It is caused by medical causes, can be
prevented through following medical advice, using herbs, continuous
following up, asking a relative, asking older women, asking a nurse or a
doctors when dangerous signs happen.
Approaches to ensure ethics were considered in the study regarding
confidentiality and informed consent. Confidentiality was achieved by the
use of locked sheets with the names of participants replaced by numbers.
All participants were informed that the information they provided during
the study would be kept confidential and used only for statistical purpose
and after finishing the study, the finding would be presented as a group
data with no personal participant’s information remained.
After explanations prior to enrollment in the study, informed
consent was obtained from all participants. Each participant was informed
that participation in the study was voluntary, and she could withdraw
from the study whenever she decided to and each one was given the
opportunity to freely refuse participation. They were free to ask any
question about the study details.
The current study concluded that studied women had high
perception levels because of having good knowledge level, good beliefs
and positive attitude toward dangerous signs of pregnancy. This answer
the first research question which was what is the perception of pregnant
women toward dangerous signs of pregnancy?
The current study also showed that there was correlation between
perception (knowledge, beliefs and attitude) toward dangerous signs of
pregnancy and socio-demographic variables. There was a high perception
level among young educated, employee women and those with enough
income. This answer the second research question that was: Is there a
relationship between perception of pregnant women toward dangerous
signs of pregnancy and their socio-demographic data(age, education,
occupation and income)?