English

Abstract

AIMS: This study aimed to find out prevalence of grand multipara, reasons for current pregnancy, knowledge and use of family planning methods, maternal and perinatal outcome in grand multipara. MATERIALS AND METHODS: The study was conducted in Department of Obstetrics and gynecology, Tertiary care centre, Bhopal during 1 year period from 1st March 2011 to 28th February 2012. It is a hospital based clinical prospective study. RESULTS: In study period 327 grand multiparous women admitted out of total obstetric admission of 13202 at Tertiary care centre, Bhopal. The prevalence of grand multiparity was 2.47%. Most of grand multipara cases belong to age group between 26-30 years mean age in the study was 30.9 year. Maximum numbers of cases were fourth para 58.4%; ninth para constitutes only 0.6%. Maximum number of cases 61% belonged to rural areas. Booked cases were only 25% and referred cases were 65%. Most of the grand multipara i.e. 91% belonged to low socioeconomic class. About 37.3% of grand multipara were illiterate. Anaemia is the most common maternal complication i.e. 36.1%. Hypertensive disorder of pregnancy is the 2nd most common (22.9%) complication. Other complications includes IUFD (14.2%), Abruptio placentae (12.6%), malpresentation (11.1%), post partum haemorrhage (10%) preterm labour (5.9%), Placenta previa (5.1%) In this study rate of caesarean section is 21% and most common indications found were foetal distress (33.3%). Rupture uterus (1.9%) was an outstanding hazard is grand multipara. Perinatal mortality was more in grand multiparous women than in lesser parity group. CONCLUSION: Grand multipara constitutes one category of high risk pregnancies Maternal and fetal mortality and morbidity increases with parity. The Grand multiparity a high risk pregnancy and its complication can be prevented by strengthening of referral services, by providing Logistic solution to communication and transport problems, Health Education to mothers and implementing compulsory family planning programme.