الفهرس 
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Abstract
Summary
Introduction:
Ante partum hemorrhage (APH) is a grave obstetrical emergency and is a main cause of maternal and perinatal mortality and morbidity. APH is any bleeding from or into the genital tract after the period of viability (20weeks of gestation) and before the end of second stage of labor. There are two main types of Ante partum hemorrhage placenta Previa and abruption placenta. Partially or completely implanted placenta in the lower uterine segment is called placenta Previa. Advancing maternal age, multiparty, prior cesarean section, and prior abortions are independent risk factors for placenta Previa (Sarojini, 2016).
Nurses play a major role in the care of a woman with APH. They are also entrusted with the outcome of the lives of both the mother and the child. Nurse should assess baseline vital signs especially the blood pressure. The physician would order monitoring of the blood pressure every 5-15 minutes. Nurse should assess fetal heart sounds to monitor the wellbeing of the fetus, monitor uterine contractions to establish the progress of labor of the mother, weigh perineal pads used during bleeding to estimate amount of blood lost and help the woman in a side lying position when bleeding occurs (Marianne, 2017).
Aim of the study:
Assess maternity nurses’ knowledge about APH.
Evaluate the effect of educational program on improving maternity nurses’ knowledge regarding APH.
Materials and method:
Research design: A quasi-experimental (pre-posttest) design was used in this study.
The study setting: This study was conducted at Women Health Hospital, Assiut University in places that deal with APH patients.
Sample size: Study was carried out on all convenient nurses who are in four places mentioned above close contact with APH patients (all nurses included 86 maternity nurse). Tools of the study: A structured interview questionnaire was developed by the researchers. It involved two parts. Part one: included personal data of maternity nurses Part two: included 21 questions to assess maternity nurse knowledge about APH and its care. And involved four section. Section 1: included 5 questions to assess maternity nurses’ knowledge about APH. Section 2: included 6 questions to assess maternity nurses’ knowledge about placenta Previa. Section 3: included 5 questions to assess maternity nurses’ knowledge about abruptio placenta. Section 4: included 5 questions to assess maternity nurses’ knowledge about care of APH.
Procedure:
Data collection of this study was taken seven months started from the beginning of February 2018, and completed by the end July 2018. This was achieved in three phases, pre intervention, intervention and post intervention.
Pre intervention phase:
Upon securing official permission to conduct the study. The researcher interviewed with each maternity nurse individually, explain the purpose of the study and method of implementation of educational program, and took their consent on participation on the study. After that personal data was taken and ask them to fill data regarding knowledge about APH as a form of pretest. This took a time from 25-35 minutes.
Intervention phase:
Carrying out of educational program which took about 22 weeks or nearly 6 months. The researcher visited the previous involved setting two days/ week. With a performance of two sessions every week to the maternity nurses, each session involved a small group with a number of 2-4 nurse. It was implemented in a form of lecture to each group. Session took a time of 60-90 minute to explain all information regarding APH (definition, types, and complications), placenta Previa (definition, types, causes, and sings &symptoms), abruptio placenta (definition, types, causes, and sings &symptoms) and care of APH. Different teaching methods was used to reach to intended objective as lecture, group discussion, problem solving and critical thinking. Also a copy of booklet was given to each nurse as a supportive material.
Post intervention phase:
After 4 weeks of the session, the researcher interviewed again with the nurses involved in the session to perform a post test that had the same pretest questions.
Results:
There is highly statistical significance difference between pre &posttest regarding total knowledge of studied maternity nurses regarding APH p-value 0.001.
Conclusion:
There was an improvement in the knowledge of maternity nurses regarding APH evidenced by the pretest and posttest knowledge scores.
Recommendation:
Study should be generalized to include maternity nurses in both governmental and health hospital.
Provide a continuous education and training programs to maternity nursing staff on APH.
Encourage nurses to update their education in the form of attending workshops, conferences related to care of APH.
supported maternity nurses with an instructional booklet regarding APH and its care to improve their knowledge and practices.
Implement a study on effect of training program on maternity nurses’ practice regarding care of APH patients.