M.Cur. / The recently introduced fetal growth monitoring technique - the symphysis fundal height measurement (SFHM) - has brought along a few problems. This technique was introduced in conjunction with the new antenatal card system. With this system the card is no longer kept at the health institution but carried by the mother. This mother carried antenatal card (MCAC) has a gravidograph on which measurements of fundal height are plotted graphically. Midwives in most clinical settings have experienced problems when making recordings on the gravidograph. In some centres doctors were also complaining that the symphysis fundal height measurements (SFHM) are plotted incorrectly. Midwives started to feel inadequate when doctors were constantly complaining that the gravidograph is not plotted correctly. The SFHM technique then became unpopular with midwives and most of them decided to go back to abdominal palpation - an old system which was used to monitor fetal growth. The problem most commonly found with the SFHM technique was that different midwives performed it differently. There was no uniformity in performance. This resulted in vast discrepancies of fluidal height measurements. Due to this, many problems arose with regard to proper management of pregnancy. A lot of literature surveyed by the researcher supported the fact that the SFHM technique was the best method for monitoring fetal growth. The graviphical display of SFHM on the gravidograph also facilitated early identification of intra-uterine growth retardation (IUGR). IUGR has also been found to be a major contributory factor in perinatal mortality. The survival rate of infants who have suffered IUGR can be increased through early diagnosis of IUGR and prompt referral. A seminar was staged by the researcher at the initial stages of the study to obtain views and opinions from other stakeholders regarding the SFHM technique and the MCAC. A considerable'amount of input was gained at this seminar and this contributed a great deal to the data needed for the completion of this study. The goal of this study is, therefore, to assess the ability of midwives in: performing the SFHM technique; and making recordings on the gravidograph section of the card. A quantitative, descriptive and exploratory design was followed. The study population consisted of a total of 15 registered midwives and 45 pregnant mothers. Each midwife was allocated 3 mothers according to selected criteria. This study was done within the context of two specific hospitals and two specific clinics. Tools were first tested for validity and reliability in a pilot study. Testing of the tools was done with the assistance of an experienced midwife researcher. No major changes were made. Data was gathered in two phases. Phase I was completed by direct observation, using a checklist. Phase II was a semi-structured interview. The medium of communication was English. Informed verbal consent was obtained from both midwives and pregnant mother subjects. Their right to refrain from participation was also explained. Data was analysed according to descriptive statistics in the form of tables and graphs. The concerns of the researcher were validated by the results in that the findings revealed that both the SFHM technique and recordings made on the gravidograph were done incorrectly in most cases. The results of this study have highlighted the need to formulate the SFHM technique standard. This would serve as guidelines and also as criteria against which performance can be measured. Delays in standardizing the technique may result in increased instead of decreased perinatal mortality rates. There is also a need to ensure that the gravidogram section of the card is filled in correctly. It is recommended that midwives should be thoroughly in-serviced about new procedures before being expected to implement them. Standards which serve as guidelines for practice should also be formulated, together with new procedures, so that excellence in practice is achieved.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:uj/uj:10044 |
| Date | 11 September 2012 |
| Creators | Malebe, Catherine Nnana |
| Source Sets | South African National ETD Portal |
| Detected Language | English |
| Type | Thesis |
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