الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
Aim of the Study: - The aim of this study was to see differences in some ecological factors Qssociated with toxaemia of pregnancy in an urban and a rural area. . the intermediate targets were to fulfil the below purposes: 1- Identification of the different socio-economic and biolo gical characteristics of the pre-eclamptic patients. 2- Identification of the past menstrual, obstetric, past medical and family history. 3- Studying the present pregnancy as regsrds: i- Presence of signs and symptoms of the disease. ii- Period of gestation. iii- Degree of severity of the condition. iv- Presence of anaemia. 4- Studying the body measurements of the patients. 5- Psychological screening for the purpose of identifying the psychological reaction is mnong the pre-eclamptic patients. 6- A trial to identify the type and quantity of ante-natal care given to the patient. The study was done by interviewing, examining and investigating the pro-eclamptic patients under study. A pilot study was carried out in February 1977 for testing the structural intervievving schedule used and to estimate the time needed for each case. A purposive salilple was taken which included every pre eclamptic patient attending the ante-natal clinics under study during the period of research which was performed in period of six months. The sample Silln up to 160 cases, 100 cases from the insurance ante-natal clinic (working patients), 35 casoS from El-Shatby ante-natal clinic, (llousevdves), and 25 cases from El-Gomrok IV1CH center (housewives) . The proposcd rural sample was not taken although the rural field work was performed over 2 months with no one case of pre-eclampsia encountered. So the study was limited to the urban sample only and any diffe~ences in the ecology of toxaemia were studied among the insured working mothers 2nd patients f:com °the i;1-8l1atby [lac. d. C.iI. c6n.tcr (llouse- wives). The results showed that: - The education of the patients and their husbands are of higher levels among the working patients than the house wives whom a great percent of them were either illeterate, read and write or have comp~eted their primary education only. Families of working patients were smaller in size, with high income/capita/month, living in a better housing con ditions in contr3st the frunilies of the non-working patientso The families of working patients were thus of high or middle and socio-economic classes in contrast to the non-working families vvhom a great percent were belohg ing to low socio-economic class. - Mean age of working- patients was (2903 ~ 507) while in the non-working, it was (2805 :t 305), although the non-working patients had married significantly earlier (18.9 ~ 3.9) than the working patients (2505 :t 5.8)0 Also the husbands of the non-working patients were significantly older (38.5 :t 10.8) than tho working husbands (34.9.:t 5.6). - l~ean age of menarche for the non-working patients was significantly earlier (13.5 :t 2.07) than the non-working patients (14.2 :t 105). - Congestive dysmenorrhoa or pre-menstrual tension was more among working patients than the non-working although not significant. .- The mean gravida for the non-working patients was signi ficantly more (3.3 ~ 1.8) than the working patients (2.16 :t. 1.8). - It was found that 58.5 of the total sample had a past obstetric history of either hypertension, edema, pro teinuria or any combinations of them. Three cases had a past obstetric history of eclaInptic fits 0 - It was found also that 28.8 of the total sample were practicing contraception by using oral pills in the last period before the present pregnancy. - The present study also revealed that 65.5 of the total sample had 2 relevent family history of hypertension, diabe~es, obesity, toxaGmias in mothers or sisters ...stc. - Psychological study using the Midd13~sex test revealed - that, anxiety, phobia, depression, hysteria were signifi cantly more among ~hG non-working patients than the working. Psychosomatic features and obsession were found to be present in 60.0 and over of the total sample. - Insured patients attended the initial visit for antenatal care usually in thc first tri~oster and to a less extent in the 2nd while t;:~ose of the 1’,1. GoR. center attended usually in the 2nd trimes.tGl~ and to some extent in the 3rd. Those of El-Shatby clinic usually payed their visit in the third trimester. - Pattern of attendance was better 2mong the insured work ing than the H.G.~. and El-Shatby patients. The patients of the fil. G.Ho were also better than those of El-Shatby clinic. Gare taken in each visit was not the adequate one in the three clinics although it was better in the insurance clinic than any vihere. Only the DoC.H. center was the only one to give tetanus vaccine and to practice routine dental care. Revealed thst lower levels of systolic and Examinations: diastolic blood pressures were more prevalent among the insured working patiGnts compared to housewives in whom, the high levels of blood pressure were the mode.