Obstetric behavior of grandmultipara- A retrospective study

ABSTRACT

This retrospective study included 1298 grandmultipara who had delivered 5 or more viable babies out of 9443 total deliveries in the year 1984 at Madina Maternity Hospital, Saudi Arabia. The incidence was 13.75%. The mean age was 35 +/- 5.2 years. 21.3% of them were para 6 and 7.1% were para 10 more. This group was compared with mothers Para 0 to 4 who had delivered in the same hospital, in the same year [8145 deliveries]. All the data were collected from the files of all patients and comparison between the two groups was carried out. It was found that the incidence of obstetrical and medical complications of pregnancy, and that of labour was increased in the grandmultipara group than in the Para 0-4 group, there was an increase in the maternal and perinatal mortality among the grandmultipara group. As all the complications of pregnancy and labour are much frequent among grandmultipara and the risk increases with parity, these women must be considered as high risk patients. They must be booked at a consultant unit, have a good sympathetic care, and have a hospital delivery. Good councelling about family planning should start during the antenatal period. The use of oxytocin is dangerous in the grandmultipara, even with the closest supervision as it may not be able to prevent sudden and catastrophic uterine rupture, the frequent occurence of malpresentations adds to this risk