Grand multiparity: Obstetric performance in Aminu Kano Teaching Hospital; Kano; Nigeria

ABSTRACT

Objective: The objective was to review the obstetric performance of booked grand multiparae. Design and Setting: A 5-year prospective observational study of cases between January 1; 2002; and December 31; 2006; was conducted in Aminu Kano Teaching Hospital; a tertiary institution; in Kano; Nigeria. Materials and Methods: The antenatal complications and pregnancy outcomes among booked grand mulitparous women (pregnancy after fifth delivery); who delivered in our labor ward; were compared with those of the booked mulitparae (parae 1-4) who delivered immediately after a grand multipara. Outcome Measures: These were obstetric factors of maternal age and parity; antepartum hemorrhage; fetal malpresentations; and multiple pregnancy. Medical complications were gestational diabetes; hypertension; anemia; and heart disease. Pregnancy outcomes measured were gestational age at delivery; birth weight; mode of delivery; postpartum hemorrhage; and maternal and perinatal mortality. Results: The age range of the grand multiparae was between 22 and 43 years; with a mean age of 29.72 + 2.07 years. The parity range was between 5 and 15; with a mean parity of 7.78 + 0.63. There was increased occurrence of gestational diabetes mellitus (OR = 12.55; CI = 6.72-23.91); hypertension (OR = 3.07; CI = 2.07-4.59); heart disease (OR = 2.01; CI = 0.70-6.08); anemia (OR = 3.16; CI = 1.42-7.24); antepartum hemorrhage (OR = 2.18; CI = 1.22-3.92); fetal malpresentations (OR = 3.04; CI = 2.38-3.88); cephalopelvic disproportion (OR = 2.09; CI = 1.33-3.29); and fetal macrosomia (OR = 2.27; CI = 1.72-3.00) among the grand multiparae compared with multiparae. Conclusion: The effects of these complications were minimized by good antenatal care