Obstetrical complications with grand multi-parity.

Abstract

862 deliveries among grand multiparas (8 or more term pregnancies) at Oneida Hospital in Kentucky from 1941 to 1953 are reviewed. The women were primarily white of low economic background gravida 8-18 73% aged 30-39. Maternal mortality rate was .35% twice that to the total hospital population. 3 women died of hypertension ruptured uterus and septicemia. Compared with deliveries among women with 0-6 previous pregnancies the grand multiparas had 6 times greated incidence of hypertensive disease 2 times more abruptio placenta 3.5 times more placenta previa 5 times more ruptured uterus 11.2 times more varicosities and about 2 times more toxemia heart disease obesity malnutrition and postpuerperal hemorrhage. 6 of these complications were still significantly higher even in comparision with the women over 30 years but para 0-3. Infant mortatlity was 7.7% or 3 times that in para 0-6. Prematurity was 9.9% but 43.4% died since over half weighed less that 2000 gm. Large infants (4000 g or more) were more common (20.3%) with 3 times greater mortality (4%). Twin pregnancy and abnormal presentation were over 2 times more common. In discussion it was observed that both physicians and their patients need to be informed that parity over 8 incurs an abruptly increasing risk.