Grandmultiparity; A Reappraisal of obstetric outcome

Abstract

Objective: To determine the obstetric outcome in terms of maternal and fetal complications related to grand multiparity.

Methodology:  This prospective cross-sectional study was conducted at the Obstetrics and Gynecology Department of Jinnah Hospital, Lahore, over a six-month period. The study included all unbooked referred cases of grand multiparous women, with their obstetric outcomes documented. Primiparous and multiparous women with parity < 5 were excluded from the study. Frequencies and percentages were calculated, and the chi-square test was applied. A p-value of < 0.05 was considered statistically significant.

Results: A total of 127 women were included in the study. Of these, 9 were fifth gravidas, and 118 had a parity > 5. The mean age was 34.33±4.11 years. Out of the subjects, 57 delivered prematurely, while 70 delivered at term. Vaginal delivery occurred in 54.3% of cases, while 33.9% required a cesarean section. Maternal complications were dominated by anemia (57.5%), followed by medical disorders (31.5%) and the need for massive blood transfusion (25.2%).

Seventy percent (70.87%) of the babies were delivered alive and healthy, while 14.17% of pregnancies resulted in miscarriages, 7.8% experienced intrauterine fetal deaths (IUD), and 7.09% of fetuses suffered from early neonatal deaths (ENND).

70.87% babies were delivered alive and healthy, 14.17% pregnancies ended up in miscarriages, 7.8% had intrauterine fetal deaths (IUD) and 7.09% fetuses had (ENND) early neonatal deaths.

Conclusion: Grand multiparity is associated with maternal and fetal complications but with provision of effective antenatal care, early referrals without delays, identification of risk factors and early intervention promotes better outcomes.