ASSESSMENT OF KNOWLEDGE, ATTITUDE, PRACTICEAND ASSOCIATED FACTORS TOWARDS RHESUS INCOMPATIBILITY (SHOTELEY) AMONG MOTHERS ATTENDING ANTENATAL CARE AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE, ADDIS ABABA, ETHIOPIA
Abstract
BACKGROUND: Rhesus incompatibility is defined as the production of maternal anti rhesus D antibodies in response to exposure to fetal rhesus antigen. It results in reticulocytosis in the bone marrow, erythroblast release from fetal liver, tissue hypoxia, increased umbilical artery and umbilical vein lactate level and hydrops fetalis. Hydrops fetalis is associated with a high mortality rate despite improved prenatal diagnostic and therapeutic interventions. Kernicterus which is one of the complications of fetal hydrops has around 10% mortality and 70% morbidity.
Objective: To assess knowledge, attitude, practice and associated factors towards Rh incompatibility (SHOTELEY) among mothers attending antenatal care at Saint Paul’s Hospital Millennium Medical College (SPHMMC).
Method: A cross-sectional analytical or comparative study was conducted among 299 selected pregnant women who were attending antenatal care at SPHMMC from first of October to November 30, 2020 GC. Sample size was determined by using a single proportion population formula, and eligible participants were selected by systematic random sampling technique. The questionnaire was adapted and modified from previously published studies. Data was collected by interviewer administered structured questionnaire after pre-test was done. Ethical assurance was received from institutional review board of SPHMMC before data collection started. Data quality was controlled by training data collectors and supervisors and checking each data for completeness and consistency during and after actual data collection. Completely filled data was coded and entered into SPSS version 25.0 for analysis. Descriptive statistics were used to see the distribution of study variables. Binary logistic regression analysis was done to see the independent predictors of level of knowledge, attitude and practice and adjusted odds ratio with p value of ≤ 0.05 and 95 % confidence interval was taken as statistically significant.
RESULT: This study result showed that only 39.1% of mothers had good level of knowledge towards Rh incompatibility. More than two third of mothers (66.7%) did not know their husband’s blood group and Rh. Only 5.7 percent of mothers knew that Rh incompatibility is because of Rh negative mother carrying Rh positive fetus. If Rh negative mother carry Rh positive fetus, only 38.5% of mothers knew that what measures should be taken to prevent Rh incompatibility. More than 96% of mothers had positive attitude and 87.6% of mothers had good level of practice towards Rh incompatibility (SHOTELEY). Only 13.0% of mothers did check their blood group and Rh before pregnancy. If they had frequent stillbirths or miscarriage because of Rh incompatibility, 78.6% of mothers stated they will go to hospital for help and the remaining 21.4% of mothers responded that they will not go to the hospital (Church or Mosque 9.7%, Herbalist 9.0%, and 2.7% of mothers believed that it is from the God).
Conclusion: Most pregnant mothers attending their ANC at SPHMMC had poor level of knowledge towards Rh incompatibility (SHOTELEY). Only few numbers of mothers knew that Rh incompatibility is because of different Rh negative mother carrying Rh positive fetus. However, most pregnant mothers had positive attitude and good practice towards Rh incompatibility (SHOTELEY).
RECOMMENDATION: Midwives, interns and residents at ANC should counsel and educate pregnant mothers to increase their awareness about Rh incompatibility (SHOTELEY), its cause and complications. The hospital should prepare the campaign for pregnant mothers attending their ANC at SPHMMC to increase their awareness knowledge towards Rh incompatibility (SHOTELEY).