The Grand Multipara in Modern Obstetrics

Abstract

From April 1985 to March 1986, 1,252 women were admitted for delivery at the Al Hada Armed Forces Hospital, Taif, Saudi Arabia. Of these, 224 (17.9%) were grand multiparas (GM) defined as mothers of parity ≥6. History, labor and delivery as well as postpartum and neonatal courses were recorded using computerized records for later statistical calculations. The obstetric and perinatal outcome was calculated comparing the GMs to para-1 mothers and para-2–5 patients (P2–5), respectively. The latter group being empirically considered as the ‘ideal’ patient group. On comparing the GM group to that of P2–5, significantly higher frequencies of intercurrent diseases, especially diabetes mellitus and gestational diabetes, were found. Among GMs, transverse lie, primary uterine inertia, fetal heart rate abnormalities, failure to progress and postpartum hemorrhage were encountered significantly more often than in the other groups. The incidence of placenta previa was likewise significantly increased among the GMs as was the number of cesarean sections, particularly those of the primary emergency type. There was no maternal mortality. The perinatal morbidity was significantly higher in the GM group. However, no significant difference in perinatal mortality was found between the groups. It is concluded that with few exceptions the GM can be safely delivered by means of modern obstetric management.

Obstetrical Outcome of Grand Multipara

“…In contrast to the study done by Munium et al 2 , who found no significant difference in the prevalence rate of caesarean section or normal delivery. However, in other studies conducted by Evaldson 13 , Ozumba 14 and Irvine 15 increased caesarean section rate was found among grand multipara which correlates with this study. In this present study it was observed that prolonged labour was 22.67%, this finding co-relates with that of other studies.…”

“…In this present study it was observed that prolonged labour was 22.67%, this finding co-relates with that of other studies. [13][14][15] This study had shown thad increased incidence of obstructed labour (11.33%) in grandmultipara. Which was consistence with other studies.…”

Trends in the Occurrence of Antenatal and Perinatal Complications with Increasing Parity

“…While many antenatal and intrapartum complications like diabetes (overt and gestational), anemia, preterm delivery, malpresentation at term, postpartum hemorrhage, macrosomia showed a significant linear increase with increasing parity as indicated by v 2 test for linear trend (Fig. 1) as also reported by many other studies [3][4][5][6][7][8][9]; there were some, like the need for labor augmentation with its attendant risks specially in women of higher parity and soft tissue injuries, which showed a significantly declining trend with increasing parity as indicated by v 2 test for linear trend (Fig. 2).…”

Multiparity and Childbirth Complications in Rural Women of Northeastern Nigerian Origi

“…It seems fair that with improved and modern perinatal care, improved perinatal outcomes for both mother and child might be assured [21][22] . In other words; high parity may not be a great cause for concern if the economy is stable, population is healthy and there is access to high quality medical care [23][24][25] .…”