Study of magnitude of grand multiparty and its perinatal outcome in a tertiary hospital of rural area in Maharashtra

ABSTRACT

Background: Grand multiparous pregnancies have been considered to be at higher risk of developing antenatal and perinatal complica?ons like pre-eclampsia, gesta?onal diabetes mellitus, anemia, antepartum hemorrhages, preterm labor, mal-presenta?on, mal-posi?on and feto-pelvic dispropor?on This study was done to know the magnitude of grand mul?para a?ending the ter?ary care center with possible complica?ons related to high parity. Objec?vesTo study the prevalence possible fetomaternal complica?ons associated with grand mul?para at rural setup. Methodology:Descrip?ve cross-sec?onal study conducted in medical college of rural area for 12 months. Grand mul?para with 5 or more deliveries before current pregnancy coming for antenatal checkup and delivery were enrolled. Antenatal history was recorded ?ll delivery and feto-maternal outcomes were noted. Results:Out of 1500 deliveries conducted during study period, 110 (7.5%) cases were grand mul?para. Majority of them (79.5%) were Muslim and 80% were anaemic. 60% delivered with FTND, and 25.4% had emergency LSCS with one intrauterine death and a single breach delivery. Predominantly preeclampsia (23.6%) and malpresenta?on (14.5%) were diagnosed as antepartum complica?ons. Almost one fi?h of them had postpartum hemorrhage which was controlled with no mortality. 13 (11.8%) grand mul?para women had s?ll birth or early neonatal death, though fetal distress was observed in 37 cases. Conclusion: Grand mul?party is s?ll a high-risk pregnancy associated with adverse maternal and fetal outcomes in our facility with mul?ple interrelated but mostly preventable causes.