Original Article Egyptian Journal of Health Care, 2022 EJHC Vol 13. No.

Prevention of Pre-eclampsia among Pregnant Women in

the Second Trimester in Rural Area
Asmaa Mahmoud Abd El Halim (1), Nadia Hamed Farahat (2), Safinaz Mohamed Sayed (3)
(1)
Master student at faculty of nursing, Ain- shams University-Cairo-Egypt.
(2)
Professor of Community health Nursing faculty of nursing, Ain- shams University
(3)
Lecturer of Community health Nursing faculty of nursing, Ain- shams University

Abstract
Background: Early identification of women at risk may help in prevention of preeclampsia
and complications of this disease. Aim of study: the study aimed to assess prevention of
preeclampsia among pregnant women in the second trimester. Subjects and methods:
Design: Descriptive exploratory research design. Setting: The study was conducted at the
selected maternal and child health centers affiliated to the Beni-Suef governorate, El-Wasta
center that include 24 MCH centers. Sample: Purposive sample of 550 pregnant women was
used. Tools: Two data collection tools were used to carry out the current study namely;
Interviewing questionnaire tool, include Part I: concerned with demographic characteristics
of the pregnant women. Part II: Assess pregnant women's knowledge about pre-eclampsia
Part III: Assess indicators of pre-eclampsia among pregnant women. Part IV: Assess
pregnant women's practices about the prevention of pre-eclampsia and risk factors
assessment tool. Results: 56.8% of the pregnant women have unsatisfactory total knowledge
about preeclampsia. Also, 91.8% of the pregnant women have satisfactory total practices
regarding preeclampsia. 83.8% of them had normal body mass index as risk factor of
preeclampsia and 98.8% of them had edema in their feet as indicator of preeclampsia.
Conclusion: More than half of the pregnant women have unsatisfactory total knowledge
about preeclampsia. Also, most of the pregnant women have satisfactory total practices
regarding preeclampsia. Majority of the pregnant women had normal blood pressure as
indicator of preeclampsia. Majority of the pregnant women had normal body mass index as
risk factor of preeclampsia. Recommendations: Providing sufficient training for women
regarding pre-eclampsia to enhance their knowledge, providing sufficient training for women
regarding pre-eclampsia to enhance their performance.
Keywords: Prevention of preeclampsia, pregnant women, Second trimester.
Introduction mg/dL. Urine dipstick can only be used if
the other methods are not available (Assis
Preeclampsia is a hypertensive et al., 2018).
disorder that is associated with pregnancy,
there is elevation in blood pressure" Pre-eclampsia is associated with
systolic blood pressure 140 mm Hg and maternal effects that may lead to significant
diastolic blood pressure 90 mm Hg" and maternal morbidity and even mortality. It
presence of proteinuria after 20 weeks’ includes and not limited to intracerebral
should be documented to be persistent over hemorrhage, transient blindness, and
2 determinations at least 4 hours apart, cardiorespiratory arrest. Permanent
unless it is greater than or equal to 160 mm neurologic sequelae from brain ischemia or
Hg systolic or greater than or equal to 110 hemorrhage are the most common causes
mm Hg diastolic. This severe elevation of maternal death, with the maternal
may be confirmed in a shorter interval for mortality rate ranging from 0-14%. Not
prompt therapy. Proteinuria is defined as only pre-eclampsia effect on mother, but
300 mg of protein in 24 hours or there is also effect on fetus, there is decrease in
protein/creatinine in urine this ratio of 0.3 placental perfusion in pre-eclampsia result

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in intrauterine growth restriction of the and Abousaif, 2017).

fetus and oligohydramnios. Perinatal death Aim of the study
is primarily related to premature delivery,
placental abruption, and intrauterine The aim of this study is to assess
asphyxia. Fetal morbidity and mortality due prevention of preeclampsia among
to gestational age at the time of eclampsia pregnant women in the second trimester
(Coroyannakis & Khalil, 2019). through:
There is clinical signs and 1. Assessing pregnant women's knowledge
symptoms of preeclampsia that involve about pre-eclampsia.
many organs, such as the liver, kidneys, 2. Assessing the risk factors of pre-
heart, lungs, brain, and systematically eclampsia among pregnant women.
involve central nervous system that 3. Assessing indicators of pre-eclampsia
includes headache, visual disturbances and among pregnant women.
seizures, on the level of renal system 4. Assessing pregnant women's practices
includes proteinuria, oliguria, abnormal about the prevention of pre-eclampsia.
kidney tests and hypertension, vascular Research questions:
system includes severe hypertension, 1. What is the pregnant women's
cardiorespiratory system includes chest knowledge about of pre-eclampsia?
pain, dyspnea, low oxygen saturation and 2. What are the risk factors of pre-
pulmonary edema. Hepatic system includes eclampsia among pregnant women?
abnormal liver function, epigastric pain, 3. What are the indicators for pre-
nausea and hematologic system includes eclampsia among pregnant women?
hemorrhage, coagulation impairment, 4. What are the pregnant women's
intravascular disseminated coagulation and practices for prevention of pre-
shock (Cripe et al., 2017). eclampsia?
A woman is at risk for pre- 5. Is there a relation between knowledge
eclampsia if she has no more than one risk of pre-eclampsia among pregnant
factors that involve antiphospholipid women and their practices for
syndrome, previous pre-eclampsia, diabetes prevention of pre-eclampsia?
mellitus type I or II, multiple pregnancy, Subjects and Methods
first pregnancy, familiar history of pre- Research design:
eclampsia, BMI 35 Kg/m, maternal age A descriptive exploratory research
<20 or >40 years old, chronic hypertension design was used to achieve the aim of the
chronic autoimmune disease, venous current study.
thromboembolism, inter-gestational
interval 10 years similar to multiple Setting:
pregnancy and chronic kidney disease The current study was conducted at
(Cuesta et al., 2019). the selected maternal and child health
Significance of the study centers affiliated to the Beni-Suef
governorate, El-Wasta center that include
In Egypt, maternal mortality ratio is 24 MCH centers. 25 % of them were
reported to be 45 per 100000 live births selected randomly namely; Kiman Elaros,
according to WHO. The incidence of Etwab, Maymoun, Ebwat, Enfast and Elatf
hypertensive disorders in pregnancy is medical center. The Family Medicine
estimated to range between 3%-10% Center includes a general outpatient clinic,
among all pregnancies. In Egypt 4.2% had a family planning clinic and a dental clinic,
pregnancy induced hypertension, 3.8 % had and children’s vaccinations unit. These
preeclampsia and eclampsia was 0.3%. centers provided services for women and
Incidence of preeclampsia was reported in their children such as measuring blood
women aged more than 40 years (Gabal pressure, weight and height, do laboratory

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investigations, and giving Tetanus  Scoring system:

injections, children vaccination pregnancy Women responses were scored two
follow up, outpatient clinics, family for the complete correct answer, one for the
planning and pharmaceutical services. partially correct answer and zero for
Subjects: incorrect answer. Mean and standard
Purposive sample was used for this deviation was calculated and then
study. The total sample size of the pregnant converted into percent score. The
women is estimated according to the knowledge was considered satisfactory if
statistical records of management of health percent score was 60% or more and
center from 2016 to 2017. The total number unsatisfactory if less than 60%
of pregnant women in these medical Part V: Pregnant women's
centers was 4927 during the year, 10% was practices about the prevention of pre-
selected. Total sample size was 550 eclampsia included following up, nutrition,
pregnant women. rest and comfort, and anxiety and stress
Data collection tools: (Wataganara et al., 2018).
Two data collection tools were used  Scoring system:
to carry out the current study namely; Practices scoring systems were
Interviewing questionnaire tool, and risk “done” and “not done” which scored one
factors assessment tool. and zero respectively. The scores of the
First Tool: Interviewing items were summed up and the total
questionnaire tool: divided by the number of items, giving a
mean score for the part. These scores were
It was written in sample Arabic converted to percent score. Total score of
language after reviewing the related women practices considered adequate if
literature, it was included four parts: total percent score was 60% or more and
 Part I: Demographic inadequate if the total percent score was
characteristics of the pregnant women less than 60%.
such as; age, educational level, occupation  Part IV: Indicators of pre-
of the pregnant women, family monthly eclampsia among pregnant women
income, number of family members, and includes headache, presences of edema,
number of rooms, crowded (>2 edema site, oliguria protein in urine, and
residents/room), uncrowded (1-2 presence of chronic disease (Kiondo et al.,
residents/room) 2017).
 Part II: Obstetric and Second Tool: Risk factors
gynecological history of the pregnant assessment:
women: such as; number of gravidas,
number of abortions, number of parities, To measure blood pressure, weigh,
types of delivery, and presences of chronic height, body mass index, presence of
diseases (Wotherspoon et al., 2017). edema, edema site, oliguria protein in urine
for the pregnant women (Tabi et al., 2016).
 Part III: Pregnant women's
Tools validity:
knowledge regarding pre-eclampsia
included meaning, signs and symptoms, Face and content validity of the
manifestation, causes, types, management, study tools was assessed by jury group
and prevention of pre-eclampsia, medcal consisted of three experts (Professors) in
investigations, chronic diseases that can community nursing from faculties of
cause preeclampsia, obesity and nursing. Jury group members judge tools
preeclampsia and predisposing factors of for comprehensiveness, accuracy and
preeclampsia (Ebrahem, 2015). clarity in language. Based on their

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recommendation’s correction, addition and investigator take 15 minutes for each tool to
/ or omission of some items was done. complete the sheet with pregnant women
Tools Reliability: Administrative Design:
The study tool was tested for its An official letter requesting permission
internal consistency by Cronbach’s Alpha. to conduct the study was directed from the
It was 0.783 for the Interviewing dean of the faculty of nursing Ain Shams
questionnaire sheet, and 0.82 for risk University to the selected maternal and child
factors assessment. health center because these health units are
Pilot study: outlets for pregnant women, affiliated to the
Beni-Suef governorate that include (Kiman
Pilot study was carried out on 10% of Elaros, Etwab, Maymoun, Ebwat, Enfast and
the total study sample (50 pregnant women) to Elatf medical center) to obtain their approval
evaluate the applicability, efficiency, clarity of to carry out this study. This letter included the
tools, assessment of feasibility of field work, aim the study and photocopy from data
beside to detect any possible obstacles that collection tools in order to get their permission
might face the investigator and interfere with and help for collection of data.
data collection. Necessary modifications were
done based on the pilot study findings such as Ethical Considerations:
(omission of some questions from tool) in Prior study conduction, ethical
order to strengthen their contents or for more approval was obtained from the scientific
simplicity and clarity. The pilot sample was research ethical committee of the faculty of
excluded from the main study sample. nursing, Ain Shams University. The
Field work: researcher met director of the selected
Data collection of the study was maternal and child health center because
started at the beginning of January 2019, and these health units are outlets for pregnant
completed by the end of March 2019. The women, affiliated to the Beni Sueif
investigator attended at the selected maternal governorate that include (Kiman Elaros,
and child health center because these health Etwab, Maymoun, Ebwat, Enfast and Elatf
units are outlets for pregnant women, medical center) to clarify the aim of the
affiliated to the Beni-Suef governorate that study and take their approval. The
include; Kiman Elaros, Etwab, Maymoun, researcher also met the pregnant women to
Ebwat, Enfast and Elatf medical center. Three explain the purpose of the study and obtain
days per week from 9am to 2pm for the their approval to participate in the study.
pregnant women is estimated according to the They were reassured about the anonymity
statistical records of management of health and confidentiality of the collected data,
center from 2016 to 2017. The total number of which was used only for the purpose of
pregnant women in these medical centers was scientific research. The subjects’ right to
4927 during the year, 10% was selected withdraw from the study at any time was
randomly in this study. Total sample size was assured.
550 pregnant women. Statistical analysis:
The investigator first explained the Data entry and statistical analysis
aim of the study to the pregnant women and were done using (SPSS) statistical software
reassures them that information collected was package. Quality control was at the stage of
treated confidentiality and that it was used coding and data entry. Data were presented
only for the purpose of the research. The using descriptive statistics in the form of
investigator meted women pregnant of MCH frequencies and percentage for qualitative
centers, and the investigator asked the variables; mean and standard deviation for
participants and wrote their answers, the quantitative variable. Qualitative
categorical variables were compared Chi-

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square (X2) test; the hypothesis that the nutrition related practices. Table (10) show
row and column variables are independent, that, 69.2% of pregnant women had
without indicating strength or direction of satisfactory practice level regarding rest
the relationship, Analysis of variance and comfort. Moreover, 91.8% of the
(ANOVA) test. Statistical significance was pregnant women have satisfactory total
considered at (P-value <0.05). practices regarding preeclampsia. 56.6% of
Results them reported suffering from anxiety and
stress.
Table (1): show that, 39.1 % of the Table (4): show that, 27.2% of the
pregnant women’s ages ranged from 20 < pregnant women had headache, 34.8% of
30 years. 38.6 % of them read and write, the pregnant women suffered from edema,
24.8 % of the pregnant women were and 98.8% of them had edema in their feet.
working, 59.7% of the pregnant women Also, finding shows that, 31.4% of the
were having governmental work. 84.0 % of pregnant women had oliguria, 20.8% of the
them have adequate monthly income, pregnant women had protein in urine, and
38.6 % of the pregnant women having only 8.2% of the pregnant women had
more than four members in their family and chronic diseases.
71.8 % of them have more than three
rooms. Table (5): show that, 84.8% of the
pregnant women had normal blood
Table (2): show that, 58.4% of pressure, 89.6% of them had normal body
pregnant women had partially correct weight, 87.4% of them had normal height,
answers regarding management of and 83.8% of them had normal body mass
preeclampsia, 86.8% of pregnant women index. Also, finding shows that, 34.8% of
had correct answer regarding the main the pregnant women suffered from edema,
signs of preeclampsia, while 81.4% of them 98.8% of them had edema in their feet, and
had partially correct answers regarding 20.8% of them had protein in urine.
prevention of preeclampsia.
Table (6): shows that, there is a
Table (3): show that, 87.8% of highly statistically significant correlation
pregnant women had satisfactory practice between total knowledge of the pregnant
level regarding health care follow up women and their total practice (P-value
practices and 83.8% of them had <0.05).
satisfactory practice level regarding

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Table (1): Demographic characteristics of pregnant women (n=550).

Demographic characteristics of pregnant women No. %
1. Age
18 < 20 years 134 26.7
20 < 30 years 195 39.1
30 - 40 years 171 34.2
Mean ± SD 26 ± 8.61
2. Educational level
- Illiterate 77 15.4
- Read and write 193 38.6
- Basic education 128 25.6
- University and more 102 20.4
3. Occupation
- Working 124 24.8
- Not working 376 75.2
 Job (n= 124)
 Governmental work 74 59.7
 Private work 28 22.6
 Free work 22 17.7
4. Family monthly income
- Adequate for family 420 84.0
- Not adequate 80 16.0
5. Number of family members
- Two 128 25.6
- Three 49 9.8
- Four 130 26.0
- More than four 193 38.6
6. Number of rooms
- One 6 1.2
- Two 4 0.8
- Three 131 26.2
- More than three 359 71.8
7. Index Crowded
- Un crowded (1-2 residents/room) 193 38.6
- (>2 residents/room) 307 61.4
Table (2): Distribution of pregnant women’s knowledge regarding preeclampsia (n=550).
Correct Partially Incorrect
Pregnant women’s knowledge regarding
correct
preeclampsia
No. % No. % No. %
1. Preeclampsia detection medical 352 70.4 12 2.4 136 27.2
investigations
2. Meaning of preeclampsia 114 22.8 20 4 366 73.2
3. Manifestations of preeclampsia 230 46 104 20.8 166 33.2
4. Causes of preeclampsia 202 40.4 243 48.6 55 11
5. Types of preeclampsia 169 33.8 13 2.6 318 63.6
6. Risk factors of preeclampsia 137 27.4 146 29.2 217 43.4
7. Chronic diseases that can cause 153 30.6 164 32.8 183 36.6
preeclampsia
8. Predisposing factors of chronic 186 37.2 122 24.4 192 38.4
diseases
9. Management of preeclampsia 202 40.4 292 58.4 6 1.2
10. Obesity and preeclampsia 259 51.8 0 0 241 48.2
11. The main signs of preeclampsia 434 86.8 0 0 66 13.2
12. Prevention of preeclampsia 93 18.6 407 81.4 0 0

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Table (3): Distribution of pregnant women according to total practices regarding

preeclampsia (n=550).
Main practice categories No. %
 Follow up practice 439 87.8
 Nutrition 419 83.8
 Rest and comfort 346 69.2
 Anxiety and stress reported practice 283 56.6
Total practices 459 91.8
Table (4): Distribution of pregnant women regarding presence of preeclampsia
indicators (n=550).
Preeclampsia indicators No. %
1. Headache
- Yes 136 27.2
- No 364 72.8
2. Presence of edema
- Yes 174 34.8
- No 326 65.2
3. Edema site (n=174)
- Feet 494 98.8
- Feet and face 6 1.2
4. Oliguria
- Yes 157 31.4
- No 328 68.6
5. Protein in urine
- Yes 104 20.8
- No 396 79.2
6. Presence of chronic diseases
- Yes 41 8.2
- No 459 91.8
Table (5): Distribution of pregnant women according to their risk factors (n=550).
Risk factors No. %
1. Blood pressure
- Normal 424 84.8
- Abnormal 76 15.2
2. Weight
- Normal 448 89.6
- Abnormal 52 10.4
3. Hight
- Normal 437 87.4
- Abnormal 63 12.6
4. BMI
- Normal 419 83.8
- Abnormal 81 16.2
7. Presence of edema
- Yes 174 34.8
- No 326 65.2
5. Edema site (n=174)
- Feet 494 98.8
- Feet and face 6 1.2
6. Oliguria
- Yes 157 31.4
- No 328 68.6
7. Protein in urine
- Yes 104 20.8
- No 396 79.2

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Original Article Egyptian Journal of Health Care, 2022 EJHC Vol 13. No.2

Table (6): Correlation between total knowledge of pregnant women and their total
practices (n=550).
Total knowledge Total practice
Total knowledge R 1 .202
P -- 0.000**
Total practice R .202 1
P 0.000** --
(**) Highly statistically significant correlation at P-value <0.05
Discussion Regarding demographic chara-
cteristics of pregnant women, regarding
Pre-eclampsia is associated with demographic characteristics, the current
maternal effects that may lead to significant study revealed that, less than two fifth of
maternal morbidity and even mortality. It the pregnant women’s ages ranged from 20
includes and not limited to intracerebral <30 years, more than one third of them
hemorrhage, transient blindness, and read and write, and also more than one
cardiorespiratory arrest. Permanent third having more than four members in
neurologic sequelae from brain ischemia or their family. Less than one quarter of the
hemorrhage are the most common causes pregnant women were working. this study
of maternal death, with the maternal was in agreement with Eze et al. (2018)
mortality rate ranging from 0-14%. Not who conducted a study entitled
only pre-eclampsia effect on mother, but "Determination, knowledge and prevalence
also effect on fetus, there is decrease in of pregnancy-induced
placental perfusion in pre-eclampsia result hypertension/eclampsia among women in
in intrauterine growth restriction of the Tanzania" and found that more than two
fetus and oligohydramnios (Behjat et al., fifth of pregnant women could read and
2017). write, and majority of them ranged from 20
A woman is at risk for pre- to 30 years. Also, this result was in
eclampsia if she has no more than one risk congruence with Savage & Hoho, (2016)
factors that involve antiphospholipid who conducted a study entitled
syndrome, previous pre-eclampsia, diabetes "Knowledge of pre-eclampsia in women
mellitus type I or II, multiple pregnancy, living in Afrcia" and found that three
first pregnancy, familiar history of pre- quarters of pregnant women were not
eclampsia, BMI 35 Kg/m, maternal age working, and only one quarter of them
<20 or >40 years old, chronic hypertension, were working at governmental work.
chronic autoimmune disease, venous Regarding demographic chara-
thrombo-embolism, intergestational cteristics, the current study revealed that,
interval 10 years similar to multiple more than half of them were having
pregnancy and chronic kidney disease governmental work. Majority of them have
(Beygi et al., 2018). adequate monthly income, and less than
So, the current study aimed to assess three quarter of them have more than three
prevention of preeclampsia among rooms. this study was accordance with
pregnant women in the second trimester Parsa et al. (2019) who conducted a study
through: assessing pregnant women's entitled "Improving the knowledge of
knowledge about pre-eclampsia, assessing pregnant women using a pre-eclampsia in
the risk factors of pre-eclampsia among America" and found that, majority of
pregnant women, assessing indicators of pregnant women have adequate monthly
pre-eclampsia among pregnant women, and income, and had governmental work.
assessing pregnant women's practices about Conversely, this result was in disagreement
the prevention of pre-eclampsia with Sheikh et al. (2016) who conducted a
study entitled "Health care provider

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Original Article Egyptian Journal of Health Care, 2022 EJHC Vol 13. No.2

knowledge and routine management of pre- conducted a study entitled "Early screening
eclampsia in Pakistan" and found that and prevention of preterm preeclampsia"
majority of pregnant women had two and found that majority of the pregnant
rooms in their home. women has satisfactory practices regarding
Also, regarding pregnant women’s preeclampsia. Conversely, this result was
knowledge about prevention of in disagreement with Skeith et al., (2020)
preeclampsia, the current study revealed who conducted a study entitled
that more than half of pregnant women had "Understanding and preventing placenta-
partially correct answers regarding mediated pregnancy complications" and
management of preeclampsia, majority of found that majority of the pregnant women
pregnant women had correct answer has unsatisfactory practices regarding
regarding the main signs of preeclampsia, preeclampsia. From the investigator point
while majority of them had partially correct of view, this result was might be due to
answers regarding prevention of pregnant women had good skills to prevent
preeclampsia preeclampsia.
Similarity, this result was supported Regarding pregnant women about
with Rebahi et al. (2018) who conducted a presence of preeclampsia indicators, the
study entitled "Risk factors for eclampsia current study revealed that more than one
in pregnant women with preeclampsia" and quarter of the pregnant women had
found that majority of women had correct headache, more than one third of the
answers about management of pregnant women suffered from edema, and
preeclampsia. Also, this result was in majority of them had edema in their feet.
agreement with Sciatti & Orabona, (2020) This result was accordance with
who conducted a study entitled "A window Alqudah et al. (2018) who conducted a
of opportunity on cardiovascular study entitled "Risk of pre‐eclampsia in
prevention: preeclampsia and fetal growth women taking metformin: a systematic
restriction" and found that majority of review and meta‐analysis" and found that
women had partially correct answers majority of women had headache and
regarding prevention of preeclampsia. . edema in pregnancy period. Also, this
From the researcher point of view, this result was supported with Agrawal et al.
result was might be due to pregnant women (2017) who conducted a study entitled
were interested to keep on their life from "Prevalence of and risk factors for
any dangers during pregnancy period. eclampsia in pregnant women" and found
Regarding pregnant women that half of the pregnant women suffered
according to total practices, the current from edema in their feet. From the
study revealed that majority of pregnant investigator point of view, this result was
women had satisfactory practice level might be due to accumulation of fluids in
regarding health care follow up practices the lower limp that appeared in the
and had satisfactory practice level swelling of legs.
regarding nutrition related practices. Also, Part VI: Risk factors of pregnant
more than two thirds of them had women with preeclampsia, regarding
satisfactory practice level regarding rest pregnant women according to their risk
and comfort. Moreover, majority of the factors, the current study revealed that
pregnant women have satisfactory total majority of the pregnant women had
practices regarding preeclampsia. More normal blood pressure, had normal body
than half of them reported suffering from weight, had normal height, and had normal
anxiety and stress. body mass index.
In the same line, this result was in This result was in agreement with
congruence with Rolnik et al. (2017) who Hürter et al. (2019) who conducted a study

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Original Article Egyptian Journal of Health Care, 2022 EJHC Vol 13. No.2

entitled "Prevention of pre-eclampsia after body weight, normal height, and normal
infertility treatment: Preconception body mass index as risk factors of
mineralization of risk factors" and found preeclampsia. There is a highly statistically
that majority of the pregnant women had significant correlation between total
normal blood pressure, and had normal knowledge of the pregnant women and
body mass index. Conversely, this result their total practices (P-value <0.05).
was in disagreement with Khanum, Naz & Recommendation
de Souza, (2018) who conducted a study
entitled "Prevention of pre-eclampsia and In the light of results of this study,
eclampsia" and found that three fifth of the the following recommendations were
pregnant women had hypotension during suggested:
pregnancy. From the investigator point of  Providing sufficient training for women
view, this result was might be due to regarding pre-eclampsia to enhance
pregnant women keep on their bodies their knowledge and practices.
during pregnant period.
 Providing sufficient training for women
Regarding correlation between total regarding pre-eclampsia to reduce
knowledge of pregnant women and their problems of pre-eclampsia during
total practices, the current study revealed pregnancy period, enhance health needs
that there is a highly statistically significant of pregnant women and provide health
correlation between total knowledge of the education for pregnant women how
pregnant women and their total practices. avoid pre-eclampsia during pregnant
This result was accordance with period.
Fratidhina et al. (2019) who conducted a  Further studies should be conducted in
study entitled "Knowledge, attitudes, and different settings.
behavior of pregnant women in preventing
of pregnancy complication" and found References
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