Rozina Yasir, Fauzia Perveen, Lubna Ali, Shaista Perveen, Subhana Tayyab.
Grandmultiparity – still an obstetric risk for developing countries.
Med Channel Jan ;16(2):264-7.

OBJECTIVE: To compare the intrapartum complications and neonatal outcome among grandmultipara to evaluate the risk . DESIGN: Cohort study PLACE AND DURATION OF STUDY: Gynae unit iv Lyari General Hospital from March 2009 to Feb 2009 PATIENTS AND METHOD: Two groups of multiparous parturients 100 in each group (Grandmultiparous >5 versus multiparous parity between 2-4) who fulfilled the inclusion criteria were studied and compared for intrapartum complications (e.g malpresentations, placental abnormalities, postpartum hemorrhage, shoulder dystocia). Neonatal records were also examined to determine the neonatal morbidity and mortality. Data was analyzed using the 95% confidence interval analysis by SPSS version 17. RESULT: Grandmultiparity comprises 33.64% of our total obstetrical admission. Grandmultiparity significantly associated with low educational status [RR 1.54,95%CI (0.98-1.95)] poorer prenatal care [RR 3.31,95%CI (2.04-5.4)] and increased maternal age [RR2.2,95% CI(1.55-3.01)] .Grandmultiparous had more intrapartum complications included obstructed labour [RR 1.5,95%CI(1.0-2.2)], Malpresentations [RR1.7,95%CI(1.2- 2.3), shoulder dystocia [RR2.02, (1.8-2.3)], abruption [RR1.76 (95%CI1.3-2.5)] and post partum hemorrhage [RR1.68 (1.25-2.26)] Perinatal mortality was higher in grand multiparous group compared to control multiparous women. PMR was –23.91% and- 10.46% respectively. CONCLUSION: Thus in conclusion our study adds weigh to the overall view that in a low socio-economic background and poor health setting grandmultiparity is still associated with a significant increased risk of classical complications said to be associated with grandmultiparity .Concerted effort should be directed for effective family planning initiatives and specialised antepartum and intrapartum management.

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