Pregnancy Outcome in Grand multiparity in Modern Setting

Antenatal, intrapartum and postpartum complications are thought to be more in grand multiparous females and this is labeled among one of high risk pregnancy group. Our aim is to find maternal and perinatal complications and outcome in grand multiparas in a tertiary care centre and should this still be considered a high risk group or not. This hospital based descriptive type of observational study conducted in Department of Obstetrics and Gynaecology, SMS Medical College, 552 grand multiparas were studied in a time period of 2 years. All the women who delivered at S.M.S. medical college and had five or more previous viable pregnancies were included in the study. Most common complications found in our study was anaemia(31.88%), then hypertensive disorders of pregnancy(10.45%) , diabetes mellitus (4.71%) , placenta previa(5.43%), malpresentation(6.16%). 3 cases of uterine rupture were seen, from which one ended up in hysterectomy. Fetal complications like still birth was 4.71%, NICU admission was 6.52% and low APGAR score i.e. <7/10 was observed in 9.42% of cases. Grand multiparity remains a risk in pregnancy and is associated with an increased prevalence of maternal and neonatal complications but it might be unjustifiable to attribute all risk to parity alone, risk assessment should be based on age, past obstetric and medical history.