JIET COLLEGE OF

NURSING

JODHPUR

SYNOPSIS
PRESENTAION
On
……..
1
Research Guide - Prof. K. Punithalakshmi
Principal, JIET College Of Nursing

Research Co-guide - Dr Preeti Chouhan

Associate Professor,
(Obstetrics and gynecology)

Research Team Members - Bhumika Singh,

Pooja Sharma,
Richa Rose,
Mohammad Ashfaq,
Anshu,
Anita

2
 Synopsis heading
A synopsis must have the following headings -
◦ Title
◦ Introduction
◦ Scope of study
◦ Need of study
◦ Review of literature
◦ Objectives of study
◦ Hypothesis
◦ Operational definition
◦ Assumption
◦ Delimitations
◦ Methodology
◦ Ethical clearance
◦ Data analysis & interpretation
◦ references

3
A descriptive study to
assess the knowledge
regarding antepartum
haemorrhage among 4th
year B.Sc. nursing
students at JIET college of
nursing, Jodhpur.

4
Introduction
“Health is real wealth & pieces of Gold and Silver.”
(Mahatma Gandhi)

Antepartum hemorrhage (APH) is a major cause of maternal

and perinatal morbidity and mortality even in modern day
obstetrics and is one of the most frequent emergencies in
obstetrics.
APH is defined as bleeding from the genital tract from the time
of viability of pregnancy for extra uterine survival to the
delivery of the baby.
The maternal complications in patients with APH are
premature labour, postpartum haemorrhage, sepsis, shock and
retained placenta. Various fetal complications are premature
baby, low birth weight, intrauterine death, congenital
malformation and birth asphyxia.

The 3 main causes of APH –

1) Placental site bleeding (70%) - placenta praevia (35%) and
abruptio placentae (35%)
2) Extra placental site bleeding (5%) – cervical erosion, polyp,
carcinoma, rupture of vein in the cervix
3) Unexplained bleeding (25%) – rupture of vasa praevia.

It also includes higher rates of cesarean section, per partum

hysterectomies, coagulation failure and even death. Fetal
complications are premature delivery, low birth weight,
intrauterine death, congenital malformation, and birth asphyxia.
The study is aimed at determining the maternal and perinatal
effects of antepartum hemorrhage in severity care hospital.

5
 Scope of study
◦ To aware the pregnant women.
◦ To reduce morbidity and mortality rate.
◦ To increase the knowledge regarding aph.

6
 Need of the study
◦ Antepartum hemorrhage can threaten both health of mother and
that of baby. This condition needs urgent medical attention.
Antepartum hemorrhage is an obstetrical emergency
contributing to a significant amount of perinatal morbidity and
mortality. Death from hemorrhage still remains a leading cause
of maternal mortality in India leading to increased MMR.
◦ Nurses play an important role in hospital sector specially in the
care of pregnant mother. Therefore, the adequate knowledge
regarding antenatal care and obstetric complication if present
need to be assessed by the nurses.
◦ Rural areas of the country are still backward and think as a myth
and curse of God about pregnancy. The need to be educated
regarding the health conditions of the pregnant mother.
◦ A knowledgeable nursing student is an asset to the institution
and the patient as well as health team. Hence it is essential that
nursing students should have adequate knowledge about Hence,
the researcher felt the need to assess the overall knowledge of
nursing students on APH.

7
 Review of literature
• Priyanka Tyagi, Nidhi Yadav, Parul Sinha, Uma Gupta
(2016) Conducted a retrospective observational study in Era’s
Lucknow Medical College and hospital, Lucknow, Uttar
Pradesh, India and patient information was obtained from
delivery records of 100 women presenting at gestational age of
28 weeks and above with APH. All patients with bleeding per
vagina after 28 weeks of gestation were included in the study
and were grouped as – placenta previa (PP), abruptio placenta
(AP) or unknown causes. Out of total 100 cases of APH,
placenta previa contributed to 80%, abruptio placenta 19% and
1% unknown causes. Overall maternal mortality was 6%.
perinatal mortality was 42%. Prevalence of low birth weight and
preterm babies was high. The conclusion was that APH is a
major cause of maternal and perinatal morbidity and mortality
which could be prevented by early registration, regular antenatal
care, early detection of high risk cases, and early referral to
higher center. The results of this study were found in good
agreement with previous studies

8
• T Kokovidou, T Sivvas, P Tsikouras (2015) Conducted a
retrospective study at a single institution from January 2005 to
December 2015. The various reasons of APH were compared to
each other regarding the parameters of the neonatal outcome. A
total of 250 (8.33%) pregnant women were included in the
study, in a total of 3000 pregnancies. The reasons of APH were
concerned to: cervical dilatation (n = 31, 12.6%), central
placental abruption (n = 37,14.9%), peripheral placental
abruption (n = 33, 13.3%), placenta previa (n = 75, 30.2%),
others non-related to pregnancy (n = 17, 6.8%), and unknown
etiology (n = 57, 22.8%). Overall, the neonates (52.8%) which
were born prematurely at gestational age below 37th week of
pregnancy (5.7%) resulted in giving birth prior to 34 weeks of
gestation, which their admission in a tertium hospital was
necessary.

9
• Dr. Archana Maurya, Dr. Sonal Arya (2014) Conducted a
study 100 cases of A.P.H admitted in Kamla Raja Hospital were
studied and inclusion criteria of patients were gestational age
more than 28 weeks with bleeding per vaginum. All the cases
were grouped as placenta previa, accidental hemorrhage, local
causes and unknown. The diagnosis was made on the basis of
history, clinical examination and few cases aided by
ultrasonography. Out of 100 cases of A.P.H., placenta previa
contributed to 71%, abruption placenta 27% and undetermined
cause 2%. Maternal mortality out of 71 cases of placenta previa
was 3 and 1 abruption placenta. Perinatal mortality was 12.69 in
placenta previa and 18.52% in abruption placenta. It was
concluded that APH is a major cause of maternal and perinatal
morbidity and mortality which could prevented by early
registration, regular antenatal care, early detection of high-risk
cases, early referral to higher center.

10
• Dr. Chandnani Kavita and Dr. Rutwa Chavda (2013)
conducted a study of 84 cases of antepartum hemorrhage cases
were admitted during the period of May 2012 to may 2013 in
Dhiraj General Hospital, a tertiary care hospital situated in rural
area of Vadodara. Singleton pregnancy with gestation age 28-
42 weeks patients were included in the study. In the study, the
incidence of antepartum hemorrhage is 2.86% and of the 84
cases 44 were of placenta previa and 40 cases were of abruptio
placenta. In this study 85.2% were emergency cases. Incidence
of APH was 62% in age group of 25-34 years of which 71%
were multipara. Ultrasonography was very much useful in
diagnosis of placenta previa (100%), while most of cases (70%)
o abruptio placenta were diagnosed clinically. At the time of
admission 60.7% were anemic and required blood transfusion.
The perinatal mortality rate of abruptio placenta is 72.5% and
placenta previa is 27.2%. From study it can be concluded that
APH is still a leading cause of maternal morbidity and mortality
in our country.

11
 Objectives of the study
◦ To assess the knowledge on antepartum haemorrhage among 4th
year B.Sc. Nursing students at JIET college of nursing.
◦ To assess the knowledge on practice of antepartum haemorrhage
among 4th year B.Sc. Nursing students at JIET college of
nursing.
◦ To associate knowledge and knowledge on practice with
selected demographic variables.

12
 Hypothesis
◦ H1- There will be significant relationship between level of
knowledge of antepartum hemorrhage among nursing students
with their selected demographic variables.

13
 Operational Definitions
◦ Assess - It refers to the statistical measure of knowledge
regarding antepartum
haemorrhage by administered structured knowledge
questionnaire.
◦ Knowledge - In this study, it refers to response received from
the respondent regarding Antepartum haemorrhage by the
nursing students following administered structural
questionnaire.
◦ Ante partum hemorrhage (APH) - In this study, it refers to the
any amount of bleeding from genital tract after the period of
viability (22 weeks of gestation) but before the delivery of baby.
◦ Nursing students – In this study, it refers to the students
studying in nursing college.

14
 Assumption
◦ Nursing students may have some knowledge about antepartum
haemorrhage.
◦ Nursing students may have inappropriate practices antepartum
haemorrhage.
◦ There may be association between demographic variables and
knowledge and knowledge on practice about antepartum
haemorrhage.

15
 Delimitations
◦ This study is de-limited to 4th year B.Sc. nursing students.
◦ This study is de-limited to students who are studying in 4 th year
B.Sc. nursing at JIET college of nursing, Jodhpur.
 

16
 Methodology
◦ Type of study: A quantitative research approach and a
descriptive non-experimental study to assess the knowledge and
knowledge on practice regarding antepartum hemorrhage among
4th year B.Sc. nursing students of JIET college.
◦ Study setting: JIET nursing college, Jodhpur.
◦ Target population: 4th year nursing students of JIET college of
nursing.
◦ Accessible population: All the students who will respond as per
convenience.
◦ Study population and sampling: The population included all
the 4th year nursing students in JIET college of nursing.
◦ Sample size: 39 nursing students.
◦ Sampling method: A convenience sampling technique will be
used to select samples.
◦ Inclusion criteria: All the nursing students willing to
participate, with understanding of English language.
◦ Exclusion criteria: All the nursing students who are sick.
◦ Data collection tool: Data will be collected from the
participants through the formulation of an online survey method
using google form.
◦ Description of tool: Google form will contain a set of
questionnaire which will be answered in a YES/NO format by
the participants. The form will have four sections as follows –
Section ‘A’ - Informed consent for the participants.
Section ‘B’ - Assessment of the demographic profile of
participants.
Section ‘C’ - Assessment of knowledge on antepartum
haemorrhage.
Section ‘D’ - Assessment of knowledge on practice of
antepartum haemorrhage.
The collected data will be given a score of 1 mark for each
correct and 0 mark for each incorrect response. Both YES and
NO will be considered as correct as per the question.

17
 The marks will be converted to percentages and graded as
follows –
0-50% = Inadequate knowledge
50-75% = Moderately adequate knowledge
>75% = Adequate knowledge
◦ Tool validity: The tool and content validity will be evaluated by
the experts in the specialty.

18
Ethical Clearance
Permission will be obtained from the management and principal
of JIET college of nursing, an informed consent will be obtained
from the participants and confidentiality will be maintained.

19
Data Analysis &
Interpretation
Data analysis and interpretation will be done by descriptive
statistics by using Microsoft excel.

20
 References
• UNESCO Case studies antepartum hemorrhage (India), 2003.
Available from:  http://www.unescobkk.org/
ips/arhweb/demographics/india2.cfm.
 
• K. Park. 2013, Park’s Textbook of Preventive and Social
Medicine, 22th Ed. Jabalpur:  Banarsidas Bhanot Publishers; P.
316. 

• A Bener, NM Saleh, MT Yousafzai, 2016, complications

regarding antepartum hemorhage  among pregnant women in the
third trimester among Arab women residing in Qatar  16:847 

• Mangal Chand Yadav, Kalpana Mehta, Vimla Choudhary ,

2009, Awareness of antepartum hemorrhage among school-
going adolescents in Banaskantha district of Gujarat Health and
Population: Perspectives and Issues Vol.32(2), 59-65 .

• Indian Journal of Advanced Nursing ISSN online (2394-7160),

ISSN print (2319-815X)  Volume I, Issue 4, Oct- Dec 2015,
Abhilash V, Knowledge on Antepartum hemorrhage  45-50
 
• Sbhandari, E A raja, A Shetty, July 2011- Dec, Knowledge and
attitude related to antepartum hemorrhage  among medical and
allied health sciences students Indian Journal of obstetrical
Health,  Vol. 23, No. 2.

• Dr. Archana Maurya, Dr. Sonal Arya (2018); Study of

Antepartum Haemorrhage & Its Maternal & Perinatal Outcome;
Int J Sci Res Publ 4(2) (ISSN: 2250-3153).
http://www.ijsrp.org/research-paper-0214.php?rp=P262314

21
• T Kokovidou, T Sivvas, P Tsikouras, January 2015 ,Awareness
of Antepartum hemorrhage among newly admitted nursing
students Nursing and Midwifery Research Journal, Vol-2, No.
1.https://www.researchgate.net/publication/309383079_Study_o
f_antepartum_haemorrhage_and_its_maternal_and_perinatal_ou
tcome

• G R Shinde, B P Vaswani, R.P. Patange, M M Laddad, R B

Bhosale an explorative KABP study on Antepartum hemorrhage
among nursing professionals. Indian J Prev Soc Med., 30, 2, 79-
84. 

• Centers for disease control and prevention (CDC). About

Antepartum hemorrhage, APH Basics, Centers for disease
control and prevention (CDC). Available at: 
https://www.cdc.gov/aph/basics/whatisaph.html.

• Abhilash V, Oct- dec 2015, knowledge on Antepartum

haemorrhage, Indian Journal of Advanced Nursing ISSN online
(2394-7160), ISSN print (2319-815X) Volume I, Issue 4. 

22