Abstract
Objective Postpartum bleeding is one of the three main causes of morbidity and mortality in the obstetric patient, mainly in developing countries. Multiple risk factors associated with the development of this complication have been described, one of which is multiparity. This study sought to determine the real effect of grand multiparity on the incidence of postpartum hemorrhage. Design Retrospective, descriptive, observational study. Population We included all patients entered in the Labor Room Database of the Santo Tomas Maternity Hospital who had a vaginal birth from April 2007 to January 2009. There were 14,123 vaginal deliveries and complete information was available for analysis in 3,573 patients. Of these, 343 met the criterion of grand multiparity (>5 pregnancies). Main outcome measures Postpartum hemorrhage, postpartum complications (retention of placenta or membranes, need to manually explore the uterine cavity, instrumental curettage, perineal tears) and perinatal outcomes. Results The risk of postpartum hemorrhage was 2.8 times higher in grand multiparous patients than in lower-parity women. Grand multiparous women were characterized by older age and poorer prenatal care. Conclusions Grand multiparity is a risk factor for the development of postpartum hemorrhage.
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