Volume 6, Issue 2 (7-2008)                   IJRM 2008, 6(2): 25-0 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Hoque M, Hoque E, Kader S B. Pregnancy complications of grandmultiparity at a rural setting of South Africa. IJRM 2008; 6 (2) :25-0
URL: http://ijrm.ir/article-1-97-en.html
Pregnancy complications of grandmultiparity at a rural setting of South Africa
Monjurul Hoque * 1, Ehsanul Hoque2 , Suriya B Kader3
1- Medical Manager, Empangeni Hospital, KwaZulu-Natal, New Germany 3610, South Africa , monjurul.hoque@kznhealth.gov.za
2- Lecturer, Statistician, Mangosuthu University of Technology, Jacobs, 4026, South Africa
3- Hospital Manager,Wentworth Hospital, Private Bag JACOBS, 4026, South Afric
Abstract:   (2489 Views)
Background: 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.
Objective: 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.
Results: 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.
Conclusion: 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.
Keywords: Pregnancy outcome, Grandmultiparity, Pregnancy complications, Rural setting.
Full-Text [PDF 45 kb]   (613 Downloads) |   |   Full-Text (HTML)  (341 Views)  
Type of Study: Original Article |
References
1. Eidelman AI, Kamar R, Schimmel MS, Baron E. The grand multipara: is she still at risk? Am J Obstet Gynecol 1998; 158: 389-392. [DOI:10.1016/0002-9378(88)90161-5]
2. Solomons B. The dangerous multipara. Lancet 1934; 2: 8-11. [DOI:10.1016/S0140-6736(00)90086-2]
3. Roman H, Robillard PY, Verspyck E, Hulsey TG, Marpeau L, Barau G. Obstetric and Neonatal Outcomes in Grand Multiparity. Am Obstet Gynecol 2004; 103: 1294- 1299. [DOI:10.1097/01.AOG.0000127426.95464.85]
4. King PA, Duthie SJ, Ma HK. Grandmultiparity: a reappraisal of risks. Int J Gynaecol Obstet 1994; 36: 13-16. [DOI:10.1016/0020-7292(91)90171-Z]
5. Seidman DS, Armor Y, Roff D, Stevenson DK, Gale R. Grandmultiparity: an obstetric or neonatal risk factors? Am J Obstet Gynecol 1988; 158: 1034 - 1039. [DOI:10.1016/0002-9378(88)90213-X]
6. Fuchs K, Peretz BA, Marcovic R, Timor-Tritsch I. The grandmultipara: is it a problem? A review of 5,785 cases. Int J Gynaecol Obstet 1985; 23: 321-325. [DOI:10.1016/0020-7292(85)90027-X]
7. Samueloff A, Mor-Yosef S, Seidman D, Rabinowitz R, Simon A, Schenker J. Grandmultiparity: a nationwide survey. Isr J Med Sci 1989; 25: 625-629.
8. Rizk DE, Khalfan M, Ezimokhai M. Obstetric outcome in the United Arab Emirates: a case control study. Arch Gynecol Obstet 2001; 264: 194-198. [DOI:10.1007/s004040000107]
9. Wilkinson D, Cutts F, Ntuli N, Abdul Karrim SS. Maternal and child health indicators in rural South African health district. S Afr Med J 1997; 87:456-459.
10. Lyrenas S. Labour in the grand multipara. Gynecol Obstet Invest 2002; 53: 6-12. [DOI:10.1159/000049403]
11. Department of Health. Guidelines for Maternity Care in South Africa - A manual for clinics, community health centers and district hospitals. Department of Health, Pretoria, 2002, 2nd Edition, ISBN 1- 875017:71-72.
12. Goldman GA, Kaplan B, Neri A, Hecht-Resnick R, Harel L, Ovadia J. The grand multipara. Eur J Obstet Gynecol Reprod Biol 1995; 61: 105-109. [DOI:10.1016/0301-2115(95)02108-J]
13. Tando TG, Bungum L. The grand multipara: maternal and neonatal complications. Acta Obstet Gynecol Acand 1987; 66:53-56. [DOI:10.3109/00016348709092954]
14. Mor-Yosef S, Seidman DS , Samueloff A, Schenker JG. The effects of the socioeconomic status on the perinatal outcome of grand multipara. Eur J Obstet Gynecol Reprod Biol 1990; 36:117-123. [DOI:10.1016/0028-2243(90)90057-8]
15. Abu-Heija AT, Chalabi HE. The great grandmultiparity: is it a risk? Int J Gynaecol Obstet 1997; 59: 213-216. [DOI:10.1016/S0020-7292(97)00198-7]
16. Roman H, Robillard PY, Verspyck E, Hulsey TC , Marpeau L, Barau G. Obstetric and neonatal outcomes in grandmultiparity. Obstet Gynecol 2004; 103: 1294-1299. [DOI:10.1097/01.AOG.0000127426.95464.85]
17. Tai C, Urquhart R. Grandmultiparity in Malaysian women. Asia Oceania J Obstet Gynaecol 1991; 17: 327-334. [DOI:10.1111/j.1447-0756.1991.tb00282.x]
18. Ellis Simonsen SM, Lyon JL, Alder SC, Varner MW. Effect of Grand Multiparity on Intrapartum and Newborn Complications in Young Women. Obstet Gynecol 2005; 106: 454 - 460. [DOI:10.1097/01.AOG.0000175839.46609.8e]
19. Babinzki A, Kerenyi T, Torok O, Grazi V, Lapinsky RH, Berkowitz RL. Perinatal outcome in grand and great-grandmultiparity: Effects of parity on obstetric risk factors. Am J Obstet Gynecol 1999; 181: 669 - 674. [DOI:10.1016/S0002-9378(99)70511-9]
20. Toohey JS, Keegan KA, Morgan MA, Francis J, Task S, de Veciana M. The dangerous multipara: fact or fiction? Am J Obstet Gynecol 1995; 172: 683 - 686. [DOI:10.1016/0002-9378(95)90593-6]
21. Scholl TO, Hediger ML, Ances IG, Cronk CE. Growth during early teenage pregnancies. Lancet 1988, 1: 710-711. [DOI:10.1016/S0140-6736(88)90205-X]
22. Bai J, Wong FM, Bauman A, Moshin M. Parity and pregnancy outcomes. Am J Obstet Gynecol 2002; 186: 274 - 278. [DOI:10.1067/mob.2002.119639]
23. Lundsberg LS, Bracken MB, Saftlas AF. Low-to-moderate gestational alcohol use and intrauterine growth retardation, low birth weight and preterm delivery. Ann Epidemiol 1997; 7: 498-508. [DOI:10.1016/S1047-2797(97)00081-1]
24. Fretts RG, Schmittdiel J, McLean FH, Usher RH, Goldman MB. Increased maternal age and the risk of fetal death. N Engl J Med 1995; 333: 953-957. [DOI:10.1056/NEJM199510123331501]
25. Olesen AW, Westergaard JG, Olsen J. Perinatal and maternal complications related to postterm delivery: A national register-based study, 1978-1993. Am J Obstet Gynecol 2003; 189: 222-227. [DOI:10.1067/mob.2003.446]
26. Bugg GJ, Atwal GS, Maresh M. Grandmultiparae in a modern setting. Br J Obstet Gynaecol 2002; 109: 249-253. [DOI:10.1111/j.1471-0528.2002.01058.x]
27. Tsoka JM, Le Seur D, Sharp BL. Maternal health services utilization in ubombo district. S Afr J Obs Gynae 2003; 9: 70 -73.
Send email to the article author

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Designed & Developed by : Yektaweb