Pregnancy complications of grandmultiparity at a rural setting of South Africa|
Hoque, Monjurul; Hoque, Ehsanul & Kader, Suriya B
Intrapartam complications such as foetal malpresentation, placental
abruption, dysfunctional labour, and postpartum haemorrhage are associated with
grandmultiparity. In developing countries and many parts of Africa and sub-Saharan
Africa, there is limited access to medical care. There is a need in these areas to identify
women whose pregnancies are at risk of complication and it is an important part of
antenatal screening and care during delivery to reduce adverse outcomes.
The objectives of this study were to evaluate the complications during
pregnancy and delivery of grandmultiparity and to compare it with other parity groups.
Materials and Methods:
A retrospective case control study was conducted targeting
women delivered at Empangeni Hospital during April to December 2004. Among all
women who delivered at the hospital, 352 grandmultimaras, 3326 nulliparas and 3772
who had parity 1 to 5, were taken as cases and controls respectively for the study.
Significantly higher rates of ante partum (1%) and post partum (2%)
haemorrhages, post term delivery (3%), and intrauterine foetal deaths (4.5%) were
observed in grandpultiparas compared to nulliparous women but there was no difference
with parity group 1-5. Assisted vaginal delivery rates were significantly lower in
grandpultiparas women (2%) compared to nulliparous (5%) group (p < 0.05) but there
was no difference with parity group 1-5. There were no significant differences in
anaemia (14%), hypertension (10%), eclampsia (0.5%) and diabetes (3%), elective and
emergency caesarean delivery (14.2%) and low-birth-weight delivery rates (13.2%)
among different parity groups.
Grandmultiparity was not safer compared to other lower parity groups.
Thus strategies are needed to guide women to seek proper care during pregnancy and if
possible to avoid pregnancy if they had higher parity.
Pregnancy outcome, Grandmultiparity, Pregnancy complications, Rural setting.