Maternal outcome of grand multipara.

This prospective comparative study was conducted to determine the incidence of grand multiparity, compare the maternal outcome of grand multiparity to low parity and identify the frequency of maternal mortality associated with obstetrical complications of grand multiparity. It was carried out in the Obstetric and Gynaecology department of Rangpur Medical College Hospital, Rangpur, during the period of 1st January to 30th September' 2003. All pregnant (>28 weeks) parous women were included and primigravida were excluded. A total 2728 pregnant patients were initially recruited on the study. From them 200 cases were randomly selected. Among them 100 cases were grand multipara (parity 4 and above) comprising study groups and 100 cases were non grand multipara (parity 1-3) consisting of control group. All relevant maternal parameter were recorded and then compared between study group and control group. According to this study the incidence of grand multiparity is 9.8%. Among the grand multipara patient 95% were suffering from anaemia of different severity (p<0.05). The incidence of hypertension and gestational diabetes in grand multipara were significantly higher than non grand multipara (45% vs. 12%) and (12% vs. 02%) respectively. The other complications like placenta praevia, abruptio placentae, multiple pregnancy, malpresentations, postpartum haemorrhage, ruptured uterus were significantly higher among grand multipara and statistically significant results were observed. Proportion of women who underwent caesarean section was also high in study group (32% vs. 21% p<0.05). During the study period 7 maternal death were observed in grand multipara and 1 maternal death in non grand multipara (p<0.05).