The grand multipara--maternal and neonatal complications.

During the period of 1974-83 the records of all grand multiparous women were analysed and compared with an equally large control group consisting of second and third parae. Antenatal complications, the management of and complications in labor, complications in the puerperium, perinatal mortality and neonatal morbidity were recorded and compared with the control group. Although there was no statistically significant difference in the frequency of abruptio placentae and placenta praevia in the groups, the increased tendency in the grand multipara group resulted in a high frequency of induced preterm delivery. There was also an increased occurrence of abnormal presentations and positions. The perinatal mortality was high, 23.5% compared with none in the control group. Furthermore there was an increased incidence of neonatal morbidity. One mother in the grand multipara group died from dissecting aortic aneurysm during the puerperium.