Talat Parveen, Tayyaba Iqbal, Tasneem Kausar.
Grand Multiparity and its Obstetrical Complications at Bahawal Victoria Hospital Bahawalpur.
Pak J Med Health Sci Jan ;8(3):706-8.

Aim: To investigate the obstetrical complications of grand-multiparity at a tertiary care hospital in Bahawalpur, Pakistan. Methods: This descriptive study was conducted at the Department of Obstetrics and Gynaecology, Bahawal Victoria Hospital Bahawalpur, Pakistan. A total of 500 un-booked and referred grand multiparous women (para 05 or above) were included in the study. The record of their obstetrical outcome was analysed on SPSS for frequency and percentages of various complications. Results: The average age of grand multiparous women was 28.12±5.89 years. Blood pressure was >140 />90 in 125(25%) of the study population. Haemoglobin was <10 G/dL in 415(83%). Mode of delivery was Caesarean section in 200(40%), spontaneous vertex delivery in 190(38%), forceps delivery in 47(9.4%) and birth before arrival in 63(12.6%) of the study population. Most common indications for Caesarean sections were malpresentation (37.5%), repeat C section (30%) and abruptio placenta (15%). Maternal mortality was documented in 8(1.6%) of grand multipara, most commonly due to hypovolemic shock. Early neonatal death was observed in 21(4.2%) and intrauterine death was seen in 88(17.5%). Conclusions: Grand multiparity is still an obstetrical challenge because of numerous hazards related to pregnancy and labour especially the maternal mortality, still births and poor fetal outcome.

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