Compilications of grand multiparity

ABSTRACT

To find out different maternal and fatal complications associated with grand multiparity. A descriptive study. The maternity ward of obstetrics and gynaecology department, Military Hospital Rawalpindi from Jan 2003 to Dec 2003. The study was carried out in Maternity ward, obstetric and gynaecology department, Military Hospital Rawalpindi, a tertiary care hospital. It included 100 cases of grandmultipara women. All antenatal patients admitted in Maternity ward, Military Hospital Rawalpindi who had five or more viable pregnancies were included in the study. A detailed history was taken with thorough physical examination and necessary investigations were carried out. For this purpose a proforma was made covering all aspects of the study. Most of the patients included in our study were ranging in age between 30-40 years. 20% were booked cases, 58% belonged to poor socioeconomic class, about 83% were with term pregnancy, 15% with preterm labour. Intrauterine death 7%. Eclampsia was seen in 4% of patients preeclampsia 9%, 5% diabetic, 45% anemic, 4% presented with obstructed labour. Malpresentation 16%, placenta praevia 5%, placental abruptio 8%. Ruptured uterus 2%, caesarean-rate 23%. Vaginal delivery ratio of 58%, retained placenta 2%. Postpartum haemorrhage 9%. Low birth weight [LBW] babies were 15%, intra uterine growth retardation [IUGR]. Macrosomia birth was 10% and 67% had apgar score of 8-10. It is concluded that grandmultipara is a still major obstetric hazard which needs active intervention by improving literay rate, health care, facilities provision of safe and effective contraception and reproductive health status