Study of magnitude of grand multiparty and its perinatal outcome in a tertiary hospital of rural area in Maharashtra

Abstract Background: Grand multiparous pregnancies have been considered to be at higher risk of developing antenatal and perinatal complications like pre-eclampsia, gestational diabetes mellitus, anemia, antepartum hemorrhages, preterm labor, mal-presentation, mal-position and feto-pelvic disproportion This study was done to know the magnitude of grand multipara attending the tertiary care center with possible complications related to high parity. Objectives:To study the prevalence possible feto-maternal complications associated with grand multipara at rural setup. Methodology:Descriptive cross-sectional study conducted in medical college of rural area for 12 months. Grand multipara with 5 or more deliveries before current pregnancy coming for antenatal checkup and delivery were enrolled. Antenatal history was recorded till delivery and feto-maternal outcomes were noted. Results:Out of 1500 deliveries conducted during study period, 110 (7.5%) cases were grand multipara. Majority of them (79.5%) were Muslim and 80% were anaemic. 60% delivered with FTND, and 25.4% had emergency LSCS with one intrauterine death and a single breach delivery. Predominantly preeclampsia (23.6%) and malpresentation (14.5%) were diagnosed as antepartum complications. Almost one fifth of them had postpartum hemorrhage which was controlled with no mortality. 13 (11.8%) grand multipara women had still birth or early neonatal death, though fetal distress was observed in 37 cases. Conclusion: Grand multiparty is still a high-risk pregnancy associated with adverse maternal and fetal outcomes in our facility with multiple interrelated but mostly preventable causes.