GRAND MULTIPARA: STILL A MAJOR RISK FACTOR?


Rita Lal, Sweta Lal, Ruchi Birendra

ABSTRACT

INTRODUCTION:  Multiparty has always been associated considered as a factor for poor maternal and neonatal outcome. It has often been described as a risk factor for variety of obstetric complications. Grand multipara has been defined as a parity of five or more and has been seen to have strong correlation with increased operative delivery and medical disorders like anemia, diabetes and hypertension.
METHOD:  A study of 8304 deliveries was conducted over a period of 1 year from September 2013 to august 2014 assessing the labour records of Rajendra Institute of Medical Sciences, Ranchi and studying the demographic pattern of the laboring patients and studying mode of delivery and associated other complications. The study group comprised of parity five and above and the others were included in the control group.
RESULT:  Over the study period there were 8304 deliveries, 422 were grand multiparas with mean age of 30 yrs. Majority of the patients in the study group were unbooked and of low socioeconomic status. The incidence of LSCS was 20% and 11% in control group and study group. Rupture uterus was frequently seen grand multipara (15% vs. 1%). The incidence of medical disorders like anemia, hypertension and diabetes was more in the grand multipara group.
CONCLUSION: Grand multipara is associated with higher incidence of caesarean section  and medical disorders like anemia, diabetes and hypertension.

Keywords: Grand multipara, rupture uterus, anemia, hypertension, malpresentation.