Shamshad Begum.
Age and parity related problems affecting out come of labor in grand multiparas.
Pak J Med Res Jan ;42(4):179-84.

Background: My aim is to evaluate age and parity related problems and out come of pregnancy and labour in grand multiparas. Study design : Prospective Study. Methods: All grand multiparas (495) who were admitted during 12 months period were included in study and were analysed for pregnancy and labour complications.Out come of labor maternal and perinatal morbidity,and mortality were assessed. Results: All patients were uneducated, mostly between 30-40years(91.3%),only 10% were booked and majority were of poor class 56%.About 86% were with term pregnancy. Preterm labor 10.9%,intrauterine death 9.2%,eclampsia 1.6%,pre eclampsia 7.65%,diabetes 7%,anemia 36.7%,obstructed labour 5.6%,malpresentations 14.7%, placenta preavia 5.4%,placental abruption ruptured uterus 3%,cesarean rate 21.6%.vaginal delivery 50.7%,retained placentas 3.8%,post partum hamorrhage 7.6%,maternal mortality 3/1000,perinatal mortality 213/1000. Conclusions: It is concluded that grandmultiparity is still a major obstetriec hazard which needs active interventon by improving literacy rate,health care facilities ,safe and effective contraception and reproductive health status.

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