Risk of Grandmultiparity on both Mother and Fetus

Abstract

The aim of this prospective study was to determine the proportion of grandmultiparae (GMP) among overall deliveries and also to study the maternal and fetal risks as well as labour outcome in association with grandmultiparity. The study included (421 GMP) as study group ( group 1) compared with (421 non-grandmultiparae ) (i.e.NGMP) ( group 2) as control group. GMP represent ( 20.39%) of all deliveries conducted in study period and has very low rate attendance to antenatal clinics than NGMP (15.2% compared to 48.6% ). Antepartum haemorrhage, malpresentation apart from cord prolapse and postpartum haemorrhage were significacntly higher among ( group 1) compared to ( group 2) (p <0.01); whereas rate of labour induction and augmentation were significantly lower with grandmultipatity ( p<0.01). The rate of caesarean section (mainly indicated for prolonged labour and malpresentation) were significantly higher among GMP compared to NGMP (p<0.01). The rate of still births and macrosomia were significantly higher among ( group 1). GMP with eight and more deliveries were distinctly in a more unfavourable situation regarding maternal and fetal risks as well as perinatal outcome. We concluded that grandmultiparity associated with substantial maternal and fetal risks, increasing maternal and perinatal morbidity and mortality. This emphasizing a strictly regular antenatal care and adoption of active family planning programs to minimize the burden of grandmultiparity on obstetric services.