https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article Nurses’ Knowledge Regarding Preeclampsia and Eclampsia in Maternity Teaching Hospital in Erbil City ABSTRACT Background and objectives: Preeclampsia is a severe blood pressure condition that pro- gresses during pregnancy. Pregnant women with preeclampsia often have high blood pressure (hypertension) and high levels of protein in their urine (proteinuria). Preeclampsia typically progresses after the 20th week of pregnancy. We would have as- sessed knowledge of them regarding preeclampsia and eclampsia, and found a differ- ence between mean of sociodemographic characteristics and the level of nurse knowledge. Methods: A quantitative, descriptive cross-sectional study was conducted at Maternity Teaching Hospital and the study was conducted from (1 the September 2021) to (December 2022). The study sample size were 150 nurses who worked in this hospital. Data was collected through interviews (face-to-face) using a questionnaire designed by the investigator. The data was analysed by SPSS software for statistical analysis Version 25. Results: The majority (45.3%) of the participants were age between 30- 39 years old, and majority (81%) of the study participants were married. The majority (46%) of study participants have a nursing diploma. Most of the nurses (32%) have six to ten years of experience as the nurse at the hospital. In this study, must of the participants (78.7%) in this study have fair knowledge of the hospital. There was a statistically significant differ- ence between the mean level of education and the of overall knowledge. Conclusion: The study concluded that the nurses had fair knowledge regarding preeclampsia and eclampsia. Based on the results of the present study, it has been rec- ommended that ongoing health educational programs, seminars and training courses to improve the knowledge of nurses in order to provide good health care for cases of preeclampsia and eclampsia and become more knowledgeable about this condition. Keywords: Nurse; Knowledge; Preeclampsia; Eclampsia Silan Muhammad Abdulrahman; Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq. (Correspondence: silan.muhammed9@gmail.com) Awaz Aziz Saied; Department of Nursing, College of Nursing, Hawler Medical University, Erbil, Iraq. 57 Received: 02/09/2022 Accepted: 30/10/2022 Published: 30/05/2024 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. mailto:silan.muhammed9@gmail.com?subject=silan.muhammed9@gmail.com https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article During a healthy pregnancy, there are nu- merous physiological changes in how vari- ous organs work. Low- grade proteinuria and alterations in renal function are com- mon occurrences during pregnancy. How- ever, one of the key signs for the clinical diagnosis of preeclampsia is new-onset proteinuria [1].Pre-eclampsia is one of the most prevalent and significant problems (potentially affecting up to 10% of pregnan- cies), and is often characterized as blood pressure greater than 140 mmHg / 90 mmHg and proteinuria greater than 300 mg / 24h at or after 20 weeks of pregnan- cy. The second most common cause of ma- ternal death worldwide is severe PE. A ma- jor factor in both maternal and foetal mor- bidity and mortality is severe preeclampsia [2].Oedema, protein in the urine, and hy- pertension are the first signs of preeclamp- sia. Headache, blurred vision, and bloating appear as the symptoms worsen, Seizures or convulsions in a pregnant woman, a woman in labour, or within 42 days after delivery who does not have a history of epilepsy are the primary symptoms of ec- lampsia. Other signs of eclampsia include muscle discomfort and pain, agitation, loss of consciousness, and stroke. Both the mother and the foetus may also pass away as a result of eclampsia and eclampsia risk factors include having a family history of the condition or having previously experi- enced both pre-eclampsia and eclampsia, being pregnant at a young age, being over 35, multi-foetal gestation, being a prim gravida, and having a poor pregnancy out- come in the past, such as intrauterine growth restriction, placenta abruption, and foetal death [3].Eclampsia is generally un- derstood to be the new start of seizures and/or an unexplained coma during preg- nancy or postpartum in a woman with signs or symptoms of preeclampsia. It is regarded as a consequence of severe preeclampsia. Eclampsia often happens at or after the 20th week of pregnancy or in the postpartum period, affecting roughly 1 in every 200 women with preeclampsia. Eighty percent of eclampsia seizures happen during labour or in the first 48 hours after delivery. Rare cases have been documented as early as 20 weeks of pregnancy and as late as 23 days after delivery [4]. Of all pregnancies, 5 to 8 percent are complicated by preeclampsia. This amounts to 8.5 million instances annually around the world. One of the three main causes of maternal death is still this condition. As a result of poorly controlled hypertension (SBP > 160 mmHg), cerebral haemorrhage is the primary cause of the majority of these maternal deaths. Other preeclampsia problems include placenta abruption, haemorrhage, retinal detachment, cortical blindness, pulmonary oedema, liver failure or rupture, convulsions, and disseminated intravascular coagulation [5].The reduction in uterine and placental blood flow that causes oligohydramnios, intrauterine growth retardation, placental abruption, foetal discomfort, and eventually foetal death is the most significant threat to the foetus during preeclampsia [6].Inadequate knowledge of health professionals in direct link with complications of pregnancy, and inability to keep up through medical knowledge, have possibly severe effects on the quality of care and increase maternal and perinatal death [7].Clinical data or biochemical markers cannot be used to predict which women will get pre- eclampsia. The incidence of eclampsia and the case fatality rate connected to it, however, have been reduced by 90% in high-income nations. Using a combination of early detection during antenatal care and improved access to hospital care for women who experience severe preeclampsia/eclampsia [8].Pre-eclampsia 58 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. INTRODUCTION https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article study samples and 48 of them either could not to participate due to giving care to pa- tients or not were available during the da- ta collection period. Informed consent was obtained from the study sample after ex- plaining the purpose of the study and providing reassurance regarding the confi- dentiality of the data. The investigators prepared a questionnaire format after re- viewing related literature and the ques- tionnaire format consisted of two parts. The first part was on the socio- demographic The questionnaire format consisted of two parts. The First part fo- cused on the socio-demographic charac- teristics of the study sample such as age, marital status (single, married, divorced, widowed), level of education (preparatory nursing school, diploma institute, bachelor degree, master degree), word unit, and years of experience. The second part con- sisted of 20 items of questions designed to assess the knowledge of nurses about preeclampsia/eclampsia and each one of the 20 items has three categories. The questionnaire was scored on a Likert scale for the scoring system. The answers from each one of the questionnaire items were recoded into numerical values by applying the following scores: Incorrect=1, I do not know=2, Correct=3. Direct face-to-face in- terview through a questionnaire was con- ducted by the researcher in the Maternity Teaching Hospital and separately with each of the participating candidates for at least 20-30 minutes and the investigator filled out the questionnaire. Twelve ex- perts in related fields validated the ques- tionnaire, and the pilot study of 15 nurses indicated that the tool was eligible for data collection. Before starting data collection, the researcher explained the research pro- cess, the purpose of the study and the aim to participants and asked each of the par- ticipants to fill out a consent form. Prior to the data collection, ethical approval was risk factors have been reported to include low socioeconomic status, a poor diet (lack of vitamins C and E), poor antenatal care, a history of pregnancy-related hypertension, extreme poverty, poor reproductive care - seeking behaviour, restricted access to quality maternal services, and low levels of medical professionals' knowledge [9]. Preeclampsia and eclampsia in pregnant women with severe symptoms can be pre- vented by early detection, quick action, accurate therapy, and prompt delivery. The absence of core knowledge leads to poor decision -making and management of emergency maternal health conditions. Additionally, inadequate knowledge can be attributed to delays in treatment and re- ferrals, appropriate knowledge is essential to correctly recognize women with preeclampsia with and without severe fea- tures. This foundational knowledge helps confirm timely evidence-based decision - making and care based on global guide- lines [10].According to the researcher’s experience, lack of knowledge leads to poor decision-making and poor manage- ment of emergency maternal health condi- tions. Furthermore, insufficient knowledge can be attributed to delays in treatment and referrals and because preeclampsia and eclampsia are common diseases in the world, and all nurses should have good knowledge related to preeclampsia and eclampsia. These were the main reasons for the researcher to assesses nurses’ knowledge regarding preeclampsia/ eclampsia in the Maternity Teaching Hospi- tal in Erbil City and found an association between sociodemographic characteristics and level of Nurse knowledge A cross-sectional study was conducted (1 the September 2021) to (December 2022). from the total 198 nurses who were work- ing in the hospital 150 were recruited as 59 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. METHODS https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article obtained from the research ethics committee at the Collage of Nursing/ Hawler Medical University (No.118 Dated October 7,2021) and formal permission was obtained from General Directorate of Health in Erbil City Kurdistan /Iraq. Also, formal permission was obtained from the Maternity Teaching Hospital administrator. The data was analysed using SPSS software for statistical analysis Version 25, to calcu- late descriptive statistical analysis (frequency and percentage). Inferential statistical analysis (One Way ANOVA) was used to determine the association between variables. P-value ≤ 0.05 is considered sta- tistically significant. Table 1: Shows the descriptive data for the socio-demographic question, including the nurse's age, marital status, level of educa- tion, word unit, and years of experience. The majority of participants (45.3%) are between the ages of 30 and 39, followed by those who are older than 39 (33.3%) and those who are between the ages of 20 and 29 (21.3%). Since their average age is 36. The majority (81.3%) of nurses were married and (18.7%) of them were single. The majority of study participants (46%) have a nursing diploma, followed by bache- lor's degrees (29.3%) and nursing prepara- tory nursing schools (24.7%), in that order. Since some of the nurses work in both the postpartum and operation units (3.3 %)., the majority of them (19.3 %) Were in high- risk area. Most of the nurses have six to ten years (32%) of experience as a nurse at the hospital followed by 1-5 years (20.7%) and 11-15 years (19.3%), more than 20 years (18.7%) and 16-20 years (9.3%), re- spectively since the average of experience is 13 years. Table 2: The nurses check the highest pro- portion of eleven items. (1-Preeclampsia is increased blood pressure 140/90mmhg before 20 weeks of gestational age, 2-Eclampsia is a severe complication of preeclampsia with convulsion, 3-Preeclampsia and eclampsia occurred in both in the second and third trimester, 4-Blurred vision, severe head- ache ,nausea, vomiting and epigastric pain are symptoms of preeclampsia, 5-lack of exercise during pregnancy is a risk factor for preeclampsia, 9-Cardiovascular disease is one of the complications of preeclamp- sia, 12-Immediate intervention in cases of convulsion is to check blood pressure,13- Calcium sulphate 60 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. RESULT Table 1: Socio-demographic data of the study sample Characteristics Subgroups n=150 F. (%) Age Group (years old) 20 - 29 32 (21.3) 30 - 39 68 (45.3) 40 and more 50 (33.4) Marital sta- tus of nurse Single 28 (18.7) Married 122 (81.3) Level of education Preparatory nursing school 37 (24.7) Diploma in nursing 69 (46) Bachelor degree 44 (29.3) Ward unit High risk 29 (19.3) Neonatal unit 21 (14) Postpartum unit 5 (3.3) Emergency 24 (16) Word unit 28 (18.7) Operation unit 5 (3.3) Post operation 19 (12.7) Delivery room 19 (12.7) Years of experience 1-5 31 ( 20.7) 6-10 48 (32) 11-15 29 (19.3) 16-20 14 (9.3) 21+ 28 (18.7) https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article 61 dose of magnesium sulphate that is giv- en in case of preeclampsia is 10gintrave- nous and 10g intramuscular) these are actually incorrect questions. Additional- ly, the nurses check the maximum per- centage of four items (6-The exact cause of preeclampsia is unknown, 8- Preeclampsia is affected on gallbladder, 19-Respiratory depression and convul- sion are signs of magnesium sulphate toxicity, 20- During urine analysis if pro- tein presence in the urine less than 300mg/24hrs is considered proteinuria during pregnancy). Table 3: Most of the participants in this study have fair knowledge of the hospital (78.7%) followed by good knowledge (18.7%) and poor knowledge (2.7%) re- spectively. Table 4: Shows there is no statistically significant difference between the mean of age groups and the measure of overall knowledge because p-values (0.295) is higher than the significant level of α=0.05. It means, there is no difference between the mean of age groups includ- ing 20-29, 30-39, and more than 39 years with measurement of both overall knowledge. Table 5: Shows there is a statistically sig- nificant difference between the mean level of education and the measure of overall knowledge because its p-value (0.029) is less than the significant level of α=0.05. It means, there is a difference between the mean level of education in- cluding preparatory, diploma, and bache- lor degree of nurses with measurement of overall knowledge. is recommended for the control of convul- sions during preeclampsia, 14-After convul- sion the nurse should be given oxygen 8 litres per minute by mask or nasal mask, 16 - Another management of eclampsia is in- serted a urinary catheter to monitor urine output and proteinuria, 17- Hydralazine and diazepam are 2 drugs used for the con- trol of blood pressure during pregnancy) as correct answers (C); the proportion of cor- rect answers from nurses is ([6/11] *100 = 54.55%) since six of them ( 2-Eclampsia is a severe complication of preeclampsia with convulsion, 3-Preeclampsia and eclampsia occurred in both in the second and third trimester, 4-Blurred vision, severe head- ache ,nausea, vomiting and epigastric pain are symptoms of preeclampsia, 9- Cardiovascular disease is one of the com- plication of preeclampsia , 14-After convul- sion the nurse should be given oxygen 4-6 litres per minute by mask or nasal mask, 16 - Another management of eclampsia is in- serted a urinary catheter to monitor urine output and proteinuria) in actually are cor- rect questions. Also, the nurses check the highest proportion of five items (7- Vitamin D and folic acid that are required in the di- et to prevent preeclampsia, 10-Tetanus toxoid vaccine is reduce risk of the onset of preeclampsia, 11- Ultrasound is the screen- ing test you can use for the detection of preeclampsia, 15- The recommended intra- venous fluid for managed eclampsia is nor- mal saline, 18- The dose of magnesium sul- phate that is given in cases of preeclampsia is 10gintravenous and 10g intramuscu- lar) .As incorrect answers (I), the propor- tion of incorrect answers from nurses is ([4/5] *100 = 80%) since four of them (7- Vitamin D and folic acid that are required in the diet to prevent preeclampsia, 10- Tetanus toxoid vaccine is the risk reduce of the onset of preeclampsia, 11- Ultra- sound is the screening test you can use for the detection of preeclampsia, 18- The Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article 62 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 2: Assessment of Nurse’s knowledge regarding Preeclampsia/Eclampsia Knowledge Incorrect I do not know Correct N (%) N (%) N (%) 1 Preeclampsia is increased blood pressure 140/90mmhg before 20 weeks of gestational age (I) 39 (26) 9 (6) 102 (68) 2 Eclampsia is a severe complication of preeclampsia with convulsion (C) 13 (8.7) 12 (8) 125 (83.3) 3 Preeclampsia and eclampsia occurred in both in the second and third trimester (C) 26 (17.3) 31 (20.7) 93 (62) 4 Blurred vision, severe headache, nausea, vomiting and epigastric pain are symptoms of preeclampsia (C) 10 (6.7) 9 (6) 131 (87.3) 5 Lack of exercise during pregnancy is a risk factor for preeclampsia (I) 53 (35.3) 40 (26.7) 57 (38) 6 The exact cause of preeclampsia is unknown (C) 25 (16.7) 65 (43.3) 60 (40) 7 Vitamin D and folic acid that required in the diet to prevent preeclampsia (I) 57 (38) 45 (30) 48 (32) 8 Preeclampsia is affected on gallbladder (C) 55 (36.7) 56 (37.3) 39 (26) 9 Cardiovascular disease is one of the complications of preeclampsia (C) 26 (17.3) 40 (26.7) 84 (56) 10 Tetanus toxoid vaccine is reduced risk of the onset of preeclampsia (I) 86 (57.3) 41 (27.3) 23 (15.3) 11 Ultrasound is the screening test you can use for de- tection of preeclampsia (I) 128 (85.3) 7 (4.7) 15 (10) 12 Immediate intervention for case of convulsion is to check blood pressure (I) 55 (36.7) 14 (9.3) 81 (54) 13 Calcium sulphate is recommended for the control of convulsion during preeclampsia (I) 53 (35.3) 30 (20) 67 (44.7) 14 After convulsion the nurse should be given oxygen 4-6 litres per minute by mask or nasal mask (C) 22 (14.7) 30 (20) 98 (65.3) 15 The recommended intravenous fluid for managed eclampsia is normal saline (C) 96 (64) 21 (14) 33 (22) 16 Another management of eclampsia is inserted a uri- nary catheter to monitor urine output and proteinuria (C) 11 (7.3) 24 (16) 115 (76.7) 17 Hydralazine and diazepam are 2 drugs used for the control of blood pressure during pregnancy (I) 43 (28.7) 40 (26.7) 67 (44.7) 18 The dose of magnesium sulphate that given in case of preeclampsia is 10gintravenous and 10g intramuscu- lar (I) 67 (44.7) 51 (34) 32 (21.3) 19 Respiratory depression and convulsion are sign of magnesium sulphate toxicity (I) 48 (32.0) 68 (45.3) 34 (22.7) 20 During urine analysis if protein presence in urine less than 300mg/24hrs is considered proteinuria during pregnancy (I) 22 (14.7) 87 (58) 41 (27.3) Notice: I: Incorrect and C: Correct https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article of α=0.05. It means, there is no difference between the mean of experience groups including 1-10, 11-20, and more than 20 years with measurement of overall knowledge. Table 6: Shows there is no statistically sig- nificant difference between the mean of experience in years and the measure of overall knowledge because p-values (0.817) is higher than the significant level 63 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. Table 3: Descriptive Statistics for Overall Response from Nurse’s Knowledge Variables Poor Fair Good N % N % N % Overall Knowledge Level 4 2.7% 118 78.7% 28 18.7% Table 4: Difference between mean of age group and measure of (Overall Knowledge) Table 5: Difference between mean of Level of Education and measure of (Overall Knowledge) Variables N Mean SD F-value P-value Overall Knowledge 1-5 31 42.968 5.199 0.202 0.937 6-10 48 42.542 4.222 11-15 29 42.724 3.945 16-20 14 42.000 4.624 21+ 28 43.179 4.714 Total 150 42.733 4.472 Variables N Mean SD F-value P-value Overall Knowledge 20 - 29 32 43.438 4.370 1.232 0.295 30 - 39 68 42.118 4.530 11-15 29 42.724 3.945 40 and more 50 43.120 4.434 Total 150 42.733 4.472 Table 6: Difference between mean of Experience in years and measure of (Overall Knowledge) Variables N Mean SD F-value P-value Overall Knowledge 1-5 31 42.968 5.199 0.202 0.937 6-10 48 42.542 4.222 11-15 29 42.724 3.945 16-20 14 42.000 4.624 21+ 28 43.179 4.714 Total 150 42.733 4.472 https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article Provinces, southern Mozambique and con- ducted with community health workers, the highest percentage of participants their ages were between (40-49,31%) [13]. Other studies disagree with the present study which was done in Mosul city, re- veals that the majority of the study's par- ticipants were between the ages of 21 and 30[16]. Another study disagrees with the present result which reveals that the ma- jority of the study's participants were be- tween the ages of 21 and 30. (50%) [14] other study disagrees with the present re- sult which reported nearby half of the studied nurses (45%) were their age rang- ing less than 30 years [ 18].Regarding mari- tal status, more than four/five of the study samples were married (81.3%), this result supported by a qualitative study conduct- ed in Nigeria in 2011–2012 that nearly all participants were married [15]. Another study agrees with the present study which reported that 62.5% of the study nurses were married [19]. This result disagrees the study conducted from 2013 to 2014 from southern Mozambique by Boene H et al. reported that most of the participants were single (47%) [13].In the present study, the highest percentage of partici- pants (46%) held diplomas degree. this re- sult supported by other studies that re- ported that the majority of respondents (46.7%) held diplomas degree [16] A previ- ous study done by bahy MA et al. reported that the majority of the nurses (86.7%) held nursing diplomas which is agrees with present study. [17] This result disagrees with a study conducted by EkbalAbd El Rheem and Nahed reported that the ma- jority of nurses (68.3%) held technical insti- tute [18]. Another study disagreed with the present study which reported that 43.8% of the study sample had a bachelor degree in nursing or secondary school nursing [19]. Another study contrasts with the present study which was conducted in Preeclampsia refers to the new beginning of hypertension, and proteinuria and ma- jor end-organ dysfunction with or without proteinuria afterward 20 weeks of gesta- tion or postpartum in a previously normo- tensive patient, 4.6 percent (95% CI 2.7- 8.2) of pregnancies globally were compli- cated by preeclampsia. The occurrence in the United States is approximately 5 per- centages, Differences in occurrence among countries reflect, at least in part, changes in the maternal age, spreading and proportion of nulliparous pregnant women in the population (11).The current study has tried to determine the knowledge of nurses regarding preeclamp- sia/eclampsia. Nurses are the most im- portant medical workers who provide health education to patients and the gen- eral population and thereby help in the prevention of disease and aid in health promotion, thus staff nurses can play a very crucial role in hospitals. A recent study has shown that the majority of nurs- es have fair knowledge about preeclamp- sia/eclampsia. The socio-demographic characteristics of nurses regarding preeclampsia/eclampsia The subjects in this study included nurses (n = 150). The highest percentage of nurs- es belonged to the age group of 30-39 years (45.3%) with a mean age of (36 ± 9.29).this result supported by other stud- ies reported that the majority of respond- ents were aged between (30-39 years) (44.5%) [12]. A previous study conducted in India among staff nurses and auxiliary nurse midwives to assess their knowledge and management of preeclampsia, had a similar mean age to the present study (36.5 ±4.8) [14]. Another study agrees with present study and reports that most par- ticipants were in the age group from of (31 - 40) years [3]. The result is disagreement with a study done in Maputo and Gaza 64 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. DISCUSSION https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article level of education and the measure of overall knowledge because its p-value (0.029) as shown in (table 5). This result is in disagreement with [13] which reported that there is no significant association be- tween the knowledge of the participant and with level of education. And there is no statistically significant difference be- tween the mean of experience in years and the measure of overall knowledge because p-values (0.817) are higher than the signifi- cant level of α=0.05 as shown in (Table 6).This result supported by another study which reported that there is no significant association between years of experience and with knowledge of participants about pregnancy induced hypertension [21].Another study supported the present result which reported that there is no sig- nificant association between years of prac- tice and with knowledge of participants [13]. This result is in disagreement with a previous study which reported that there is a significant association between the overall knowledge of participant and with years of experience [12].(Table 4) shows there is no statistically significant differ- ence between the mean of age groups and the measure of overall knowledge because p-values (0.295) is higher than the signifi- cant level of α=0.05.This result is support- ed by a previous study which conducted in Iraq at Mosul Teaching Hospitals which re- vealed that there are no significant rela- tionships between study group outcomes (pre-test and post-test) and with all demo- graphic characteristic [16].A previous study reported that there is a significant associa- tion between age and the knowledge of participants; this result is in contrast with the present result[13]. Bangladesh and stated that more than half of the study participants had a bachelor in nursing and less than one third had a di- ploma[20] In the present, study the major- ity of nurses working in high –risk depart- ment (19.3 percent). Most of the nurses had six to ten years (32%) of experience as nurses at the hospital, this is result sup- ported by [12] which reported that most of the study participant had 5 to 10 years of experience 35%. This result is in disa- greement with a previous study which conducted by Hendiya IE which reported that more than half of the study partici- pants had experienced less than five years [19].Another study in contrast with the present study which reported that the ma- jority of study participants had (1-5) years of experience [16].Assessment of Nurse’s knowledge regarding Preeclampsia/ Eclampsia This research revealed that the majority of the nurses had fair knowledge (78.7%) followed by good knowledge (18.7%) and poor knowledge (2.7%) re- garding pre-eclampsia/eclampsia. This re- sult is supported by other study which re- ported that more than half of them 58.80% had fair knowledge before inter- vention [19]. A descriptive cross-sectional study conducted in Lagos, southwest Nige- ria among health care providers which re- ported that study participants had average knowledge about pre-eclampsia. This re- sult is in contrast to the present result [12].Another study disagreed with the pre- sent result which reported that 53.3 % of nurses had poor knowledge the before implementation of the educational pro- gram. Then, after implementation, 70 % of them had excellent knowledge [16]. Comparison between overall knowledge and demographic characteristics of nurses Regarding the comparison between over- all knowledge and level of education, it has been found that there is a statistically significant difference between the mean 65 Copyright ©2024 The Author(s). This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/ https://doi.org/10.15218/ejnm.2024.06 Erbil j. nurs. midwifery, Vol. 7, No. (1), May 2024 Original Article Available from: doi:www.noveltyjournals.com [Accessed: 5th July 2022. [5] G. Lambert, J. F. brIchant, G. hartsteIn, V. bonhomme and P. Y. dewandre. Preeclamp- sia: an update. Acta Anaesthesiol Belg. 2014;65(4):137-49. Available from:_Preclamsia-with-cover-page-v2.pdf (d1wqtxts1xzle7.cloudfront.net) : [Accessed: 6th July 2022. [6] Rahmati R, Mohebbi Dehnavi Z, Kamali Z, Mohebbi Dehnavi A. The effect of Mobile- based and Lecture-Based training methods on Midwives' knowledge regarding Manage- ment of Pre-Eclampsia/Eclampsia. Journal of Midwifery and Reproductive Health. 2018 Oct 1;6(4):1430-6. 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This is an Open Access article which licensed under the terms and conditions of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. It permits no additional restrictions on use, distribution, and reproduction in any medium provided the original work is properly cited. https://creativecommons.org/licenses/by-nc-sa/4.0/