The challenge of grandmultiparity in obstetric practice.

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dc.contributor.authorRayamajhi, Ren_US
dc.contributor.authorThapa, Men_US
dc.contributor.authorPande, Sen_US
dc.date.accessioned2009-05-28T03:56:43Z
dc.date.available2009-05-28T03:56:43Z
dc.date.issued2006-01-08en_US
dc.descriptionKathmandu University Medical Journal.en_US
dc.description.abstractINTRODUCTION: Traditionally grandmultiparity has been considered to be an obstetric hazard both to the mother and foetus. Compounding factors are low socioeconomic status, poor female literacy and social deprivation. In developed populations with improved and optimal obstetric services, parity per se is no longer considered a significant risk for adverse obstetric and perinatal outcome. OBJECTIVES: To compare the obstetric and perinatal outcome between grandmultiparas and second gravidas with previous one delivery as well as analyse certain socio demographic features in the two groups. METHODOLOGY: Case records from Maternity Hospital, Kathmandu, an inner city tertiary care centre were retrospectively studied. 106 cases of grandmultiparous patients were compared with 110 cases of second gravidas who had previously delivered once which was taken as the control group. Biosocial features as well as obstetric and perinatal outcome were analyzed. RESULTS: Rural residents comprised 60.4% of the grandmultiparous group versus 27.7% of the control group. A predominance of early marriage as well as an older age profile was noted in the grandmultipara. ANC attendance was documented to be much lower among grandmultipara with 26.4% having absolutely no antenatal care. A higher frequency of hypertensive disorders in pregnancy, preterm birth, anaemia, malpresentations, multiple pregnancy and premature rupture of membranes, postpartum haemorrhage and retained placenta was noted in the grandmultipara which also had a slightly higher caesarean delivery rate. The salient adverse perinatal outcome was found to be intrauterine foetal death, preterm birth and neonatal sepsis. CONCLUSION: In our set up, grandmultiparity continues to challenge our obstetric practice with its associated increased likelihood of maternal and perinatal complications. Concerted effort should be directed to reducing high parity in the community through effective family planning initiatives and specialized antepartum and intrapartum supervision of this group should be available.en_US
dc.description.affiliationDepartment of Obstetrics and Gynaecology, Kathmandu Medical College, Sinamangal, Nepal. roshantr@hotmail.comen_US
dc.identifier.citationRayamajhi R, Thapa M, Pande S. The challenge of grandmultiparity in obstetric practice. Kathmandu University Medical Journal. 2006 Jan-Mar; 4(1): 70-4en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/46155
dc.language.isoengen_US
dc.source.urihttps://www.kumj.com.npen_US
dc.source.urihttps://kumj.com.np/ftp/issue/13/70-74.pdfen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshInfant, Newbornen_US
dc.subject.meshInfant, Newborn, Diseases --epidemiologyen_US
dc.subject.meshMarriageen_US
dc.subject.meshParityen_US
dc.subject.meshPregnancyen_US
dc.subject.meshPregnancy Complications --epidemiologyen_US
dc.subject.meshPrenatal Care --utilizationen_US
dc.subject.meshRetrospective Studiesen_US
dc.subject.meshRural Populationen_US
dc.titleThe challenge of grandmultiparity in obstetric practice.en_US
dc.typeComparative Studyen_US
dc.typeJournal Articleen_US
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