ABSTRACT
Four hundred and thirty-one grandmultiparae and 1,070 less parous women who delivered at Civil Hospital, Karachi over a 2-year period (Jan. 1982 to Dec. 1983) have been reviewed retrospectively. The purpose was to estimate the incidence of grandmultiparity at this hospital and compare the incidence of obstetric and medical complications in the grandmultiparae with the less parous women. A higher incidence of anaemia, spontaneous abortions, abruptio placentae, postpartum haemorrhage, spontaneous uterine rupture and fetal loss was found in the grandmultiparae compared with other parturients. The grandmultipara continues to be a "high-risk" obstetric problem.
PIP: A total of 1501 women who delivered is the Civil Hospital in Karachi over a 2-year period Pakistan, were investigated retrospectively to ascertain the degree of complications in multiparous women. 431 (28.7%) women were grandmultiparae who had delivered 5 times or more, and 1070 (71.2%) were para fewer times. The youngest grandmultipara was 17 years old, and 26% were under 30, although most (38.3%) were in the 35-39 age group. There was a higher incidence of various complications in grandmultiparae: anemia in 64.3% vs. 45.7% in less parous women, abortion rate of 16% vs. 6.5%, abruptio placentae in 14.4% vs. 6w, and postpartum hemorrhage in 6% vs. 3%. Some complications were less frequent in grandmultiparae than in the other group: cephalopelvic disproportion in 2% vs. 10% in less parous women, obstructed labor in 2.3% vs. 10.5%, and cesarean section in 16.5% vs. 23.5% The 2% rate of uterine rupture in grandmultiparae was the result of obstructed labor, misuse of oxytoxics, and ineptness of midwives, whereas the 1% rate in the other group was caused by previous cesarean section. there was an 18% rate of stillbirths in grandmultiparae vs. 12.5% in others, most of them attributable to placental abruption, hypertension, or obstructed labor. The maternal mortality rate was 8/1000 births for grandmultiparae and 7/1000 births for less parous women, most of the deaths were the result of hemorrhage and uterine rupture. These data indicate a higher rate of incidence of serious complications in grandmultiparae whose frequency is even higher in rural areas. Excessive deliveries can endanger the lives of both the mother and the fetus.
