Share This Article:

Grand-multiparity: Is it still an obstetric risk?

Abstract Full-Text HTML Download Download as PDF (Size:121KB) PP. 411-415
DOI: 10.4236/ojog.2013.34075    7,399 Downloads   10,152 Views   Citations

ABSTRACT

Background: Grand-multiparity has been known to be an obstetric risk because of the documented complications associated with the condition, and it is an indication for booking in a tertiary health institution. The increase use of contraceptives and improved health care delivery is expected to reduce both the prevalence and complications of this condition. Aims and Objectives: To determine the prevalence of grandmultiparity, and if it is still associated with the previously documented complications in the obstetric population presenting at Ladoke Akintola University of Technology (LAUTECH) Teaching Hospital, Osogbo. Materials and Methods: A case controlled retrospective study of grand-multiparous women presenting in our institution over a period of ten years. All grandmultiparous women within the study period were identified from the labour ward register, and women with parity 2 - 4 served as control. Statistical analysis was done using SPSS 14. Statistical significance was set at p < 0.05. Logistic regression was done to adjust for confounding variables. Result: There were 5126 deliveries during the study period, and grand-multiparous constituted 128 (2.49%) of these deliveries. Grand-multiparity was found to be associated with pre-labour rupture of membranes, 16.2% versus 4.0% (p = 0.004), hypertensive diseases in pregnancy, 27.1% versus 8.1% (p = 0.001), placenta praevia, 15.3% versus 4.0% (p = 0.007) and other medical illnesses, 23.2% versus 6.1% (p = 0.001). Post-partum haemorrhage, anaemia, puerperal sepsis and urinary tract infections were found to be significantly commoner in the grand-multiparous than in the lower parity group (p < 0.05). After adjusting for confounding variables grand-multiparity was still found to be significantly associated with complications at delivery (OR = 2.70; 95% CI 1.13 - 6.48) and poor fetal outcome (OR = 2.28; 95% CI 1.11 - 4.65). Conclusion: Although the prevalence of grand-multiparity is on the downward trend, it still remained an obstetric risk, therefore, the importance of booking and delivery in a well-equipped facility should be emphasized among the obstetric population so as to reduce the complications that were found to be associated with the condition.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Afolabi, A. and Adeyemi, A. (2013) Grand-multiparity: Is it still an obstetric risk?. Open Journal of Obstetrics and Gynecology, 3, 411-415. doi: 10.4236/ojog.2013.34075.

References

[1] Solomon, B. (1934) The dangerous multipara. Lancet, 2, 8-11.
[2] Centers for Disease Control and Prevention (2004) National Center for Health Statistics: NCHS definitions. National Survey of Family Growth.
[3] Ogbe, A.E., Ogbe, B.P. and Ekwempu, C. (2010) Obstetric outcome in grand-multiparous women in Jos University Teaching Hospital. Jos Journal of Medicine, 6, 1-5.
[4] DieJomaoh, F.M.E., Omene, J.A., Omu, A.E. and Faal, M.K.B. (1985) The problems of grandmultiparity as seen at Benin Teaching Hospital, Benin-City, Nigeria. Tropical Journal of Obstetrics and Gynaecology, 5, 13-17.
[5] Eze, J.N., Okaro, J.M. and Okafor, M.H. (2006) Outcome of pregnancy in the grandmultipara in Enugu, Nigeria. Tropical Journal of Obstetrics and Gynaecology, 23, 8-11. doi:10.4314/tjog.v23i1.14555
[6] Kuti, O., Dare F.O. and Ogunniyi, S.O. (2001) Grandmultiparity: Mothers own reason for the index pregnancy. Tropical Journal of Obstetrics and Gynaecology, 18, 31-33. doi:10.4314/tjog.v18i1.14447
[7] Mutihir, J.T. (2005) Obstetric outcome of the grandmultpara in Jos, Nigeria. Journal of Medicine in the Tropics, 7, 14-20.
[8] Yasir, R., Perveen, F.Z., Ali, L., Perveen, S. and Tayyab, S. (2010) Grand-multiparity still an obstetric risk for developing countries. Medical Channel, 16, 264-268.
[9] Abro, S.T., Shaikh, S., Shaikh, F.B. and Baloch, R. (2009) Obstetrical complication in grand-multiparity. Medical Channel, 15, 53-58.
[10] Kelly, A. and Gail, L. (2008) Preterm spontaneous uterine rupture in a non-labouring grand multipara: A case report. Journal of Obstetrics and Gynaecology Canada, 30, 586-589.
[11] Shamshad, B. (2004) Age and parity related problems affecting outcome of labor in grand multiparous. Pakistan Journal of Medical Sciences, 42, 179-184.
[12] Bugg, G.J., Atwal, G.S. and Marchs, M. (2002) Grandmultipara in modern setting. British Journal of Obstetrics and Gynaecology, 109, 249-253.
[13] Benecke, C., Siebert, T.I., Kruger, T.F. and Grove, D. (2005) Antepartum and intrapartum complications in grandmultiparous patients compared with multiparous patients at Tygerberg Hospital. South African Journal of Obstetrics and Gynaecology, 11, 1-3
[14] Humphrey, M.D. (2003) Is grand multiparity an independent predictor of pregnancy risk? A retrospective observational study. Medical Journal of Australia, 179, 294-296.
[15] Omole-Ohonsi, A. and Ashimi, A.O. (2011) Obstetric performance in Amino Kano. Nigerian Journal of Clinical Practice, 14, 6-9. doi:10.4103/1119-3077.79231
[16] Adeyemi, A.S., Adekanle, D.A. and Komolafe, J.O. (2008) Pattern of contraceptives choice among the married women attending the family planning clinic of a tertiary health institution. Nigerian Journal of Medicine, 17, 67-70. doi:10.4314/njm.v17i1.37359
[17] Villar, J., Ba’aqeel, H., Piaqqio, G., Lumbiganon, P., MiquelBelizan, J., Farnot, U., et al. (2001) WHO antenatal care randomised controlled trial for the evaluation of a new model of routine antenatal care. Lancet, 19, 1551-1564.
[18] Rozina, Y., Fauzia, P., Lubna, A., Shaista, P. and Subhana, T. (2010) Grand-multiparity still an obstetric risk for developing countries. Medical Channel, 16, 265-267.

  
comments powered by Disqus

Copyright © 2019 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.