FREQUENCY OF GRAND MULTIPARITY AND ITS FETOMATERNAL OUTCOME AT LIAQUAT UNIVERSITY HOSPITAL, HYDERABAD

OBJECTIVE: To determine the frequency of grand multiparity and its effect on maternal and fetal outcome in our tertiary care facility. DESIGN: A descriptive study. PLACE AND DURATION: Department of Obstetrics and Gynaecology (Unit I), Liaquat University Hospital Hyderabad-Sindh, Pakistan; from 20 February to 20 July 2006. SUBJECTS AND METHODS: All unbooked and referred grandmultipara women were included in the study. Booked primipara women and women with preexisting medical disorders were excluded. All the information collected on a form by taking history, performing an examination and laboratory investigations was analyzed using SPSS version 10.0. RESULTS: During the study period, a total of 630 deliveries were conducted in our unit and among them 100 (15.9% ) women were grand multipara. Most of these women belonged to age group 26-30 years (n=40). A high frequency of anaemia (90%), followed by antepartum haemorrhage (28%), obstructed labor (21%), postpartum haemorrhage (19%) and hypertension (18%) was found in these cases. Fetal loss was observed in 25% of grand multiparas. CONCLUSION: Grand multiparity is still a high risk pregnancy in our facility. The causes are complex, multiple and interrelated but mostly preventable. In our study, grand multiparity was also associated with adverse maternal and fetal outcomes. Hence, there is a need for proper pregnancy evaluation and regular antenatal checkup, intrapartum care and postnatal follow up to improve the maternal care in women.