Maternal complications of high parity

ABSTRACT

The effect of parity on 6,794 patients who att4ended Al-Galaa Maternity Hospital, Cairo, over a period of 20 months was studied. Patients were classified into 3 different parity groups, vis. para 1, para 2-4 and para 5 or more [grand multiparae]; the last group constituting 26.18% of the total number of patients. The study showed that grand multiparae [G.M.] had a higher incidence of hypertensive disorders [including pre-eclampsia] and diabetes than other groups. Certain obstetric complications as placenta praevia, abruptio placentgae, rupture of the uterus and postpartum haemorrhagae occurred more frequently in grand multiparae; also, the incidence of destructive procedures and emergency hysterectomy was higher in the G.M. group compared with other groups. On the other hand, primiparae had a lower incidence of spontaneous vaginal delivery and a higher incidence of prolonged/obstructed labour and instrumental vaginal delivery than grand multiparae. The least incidence of abnormal positions of the vertex was in the para 2-4 group. Parity had no effect on the incidence of cardiovascular, urinary or gastro-intestinal complications during pregnancy and did not affect the rate of caesarean section, breech delivery or retention of the placenta during labour. When maternal mortality was related to parity, it was found to follow an approximately linear increasing curve