The Effect of Educational Intervention About Screening Preeclampsia on Midwive’ Knowledge, Implementation and Incidence Rate of Severe Preeclampsia

Abstract

Preeclampsia affects 2-8% of pregnancies globally, leading to 60,000 maternal deaths and over 500,000 preterm births. The incidence of severe preeclampsia in Rehatta Hospital, Jepara, Central Java, April 2023 to April 2024 was 79 cases. The placement of midwives in village areas is an improvement in the quality and distribution of services in reducing the mortality rate of mothers and children under five. The purpose of the study is to assess the impact of an educational program on midwives' knowledge, preeclampsia screening activities at primary health facilities, the number of pregnant women requiring ICU/HCU care and maternal mortality rates. Experimental study of pre-post-test one group design by educating 68 midwives at primary health facilities in Jepara Regency. The effectiveness of education was assessed based on differences in midwives' knowledge levels, preeclampsia screening activities at primary health facilities, the number of pregnant women requiring ICU/HCU care and maternal mortality rates. The study was conducted between April 2023 - August 2024 at Primary Health Facilities and Rehatta Regional Hospital, Jepara Regency. Data were analyzed using the SPSS statistical tool edition 29. Educational interventions can raise midwives' knowledge levels considerably (p<0.001). The distribution of preeclampsia screening actions varied significantly between the pre- and post-education stages (p<0.001). Giving midwives education raised the chance of preeclampsia screening implementation 4.30x (RR 4.30; CI95% 2.52-7.35). The distribution of referrals between the study groups showed a significant difference (p=0.002), with intended referrals being substantially more common in the post-education phase. The chance of intended referrals increased by 7.41x (RR 7.41; CI95% 1.70-32.29) when midwives received education. Giving midwives education was able to lower the number of patients needing ICU/HCU care (22.8% to 9.1%) and the mortality rate (3.8% to 0%), even though there was no statistically significant effect. When midwives at primary health centres received education, their level of expertise, preeclampsia screening practices, and planned referrals all increased significantly.