Grand Multiparity and Obstetric Complications:a Comparative Study with Women of Low Parity in a Tertiary Care Hospital

Objective: Aim of this study was to compare obstetric complications in grand multipara and women of low parity in a government hospital of tertiary care level. Design: Descriptive/ Analytical Place and Duration: Department of Obstetrics & Gynaecology Civil Hospital karachi from 1st July 2015 till 30th December 2015 Methods: All women attending OPD/ emergency of CHK meeting the inclusion criteria were selected after taking an informed consent. Group I included grandmultipara of parity more than 5 and group II comprised of women of low parity (para1-3). Study variables included age, parity, gestational age, anaemia, antepartum haemorrhage, malpresentations, mode of delivery, postpartum haemorrhage, stillbirth, miscarriage and neonatal death. All information was recorded on a predesigned questionnaire. All data was entered on SPSS Version 13 for analysis. Results: Mean age of grandmultipara was 33.16 years and that of low parous women was 28.3 4 years. Mean parity of grandmultipara and multipara was six and 3 respectively. Mean gestational age was 38 weeks for both groups. Majority of patients were booked including 52% of grandmultipara and 62% multipara. Previous history of miscarriage was present in 38% of grandmultipara and 8 % of multipara. History of stillbirth was present in 20% of grandmultipara and 6% of multipara, while 6 % grandmultipara and 2% multipara gave history of intrauterine death. Anaemia was noted in 79% multipara and 78% of grandmultipara, the incidence being almost same in both groups. Abruptio placentae was seen more common in grandmultipara (16%) than multipara (6%). Malpresentations were present in 17% of grandmultipara and 8% of multipara. Majority of patients in both groups delivered vaginally. Caesarean section rate was 4 % in grandmultipara and 22 % in multipara but instrumental delivery was more common in grandmultipara (18 % Vs 4 %). Neonatal death occurred significantly more (22%) in grandmultipara than multipara (2%). Conclusion: Grand multiparity results in increased risk of adverse maternal and perinatal outcome.