The problem of grandmultiparity in current obstetric practice

Abstract

A retrospective analysis of 646 Arab grandmultiparas who booked for hospital confinement between 1983 and 1985 was carried out. The results were compared with that of non-grandmultiparas during the same period. In the grandmultiparas, the incidences of gestational diabetes, hypertension rheumatic heart disease, antepartum, postpartum hemorrhage and macrosomic infants were increased. However, contrary to some previous reports the incidences of anemia, cesarean sections, induced labor, dysmaturity and perinatal deaths were decreased. This is thought to be due to the provision of modern specialist perinatal care and improved socioeconomic standards.

PIP: A retrospective analysis of 646 Arab grandmultiparas who booked for hospital confinement at the King Abdul Aziz University Hospital in Riyadh, Saudi Arabia between 1983 and 1985 was carried out. Results were compared with that of nongrandmultiparas during the same period. In the grandmultiparas, the incidences of gestational diabetes, hypertension, rheumatic heart disease, antepartum, pospartum hemorrhage, and macrosomic infants were increased. However, contrary to some previous reports the incidences of anemia, cesariean sections, induced labor, dysmaturity and perinatal deaths were decreased. This is thought to be due to the provision of modern specialist perinatal care and improved socioeconomic standards. In communities where poor socioeconomic standards and inadequate health services still prevail, grandmultiparity is to be regarded as a risk factor associated with increased maternal and fetal morbidity and mortality. Under the improved conditions of present day obstetrics, including competent clinical staff, the grandmultipara faces the same risk to her life during pregnancy as the woman with lesser parity. The sample in this analysis ranged in age from 18 to 43 years with mean age at 33 years. 195 (30%) were older than 35 years. This is a similar age distribution to other centers in Saudi Arabia and in Malay and Indian grandmultipara of Singapore.