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Original Research

RMJ. 2015; 40(3): 307-310


Primary cesarean section in grandmultiparity

Nazia Hashim, Farzana Nasir, Aisha Razzaq, Sonia Naqvi, Nargis Somroo.

Abstract
Objective:
To find the association of grandmultiparity with intrapartum complications as well as perinatal morbidity and mortality.
Materials &Methods:
This prospective, case control study was conducted in the department of Obstetric and Gynaecology, Sir Syed Hospital, a tertiary care hospital in Karachi. Sir Syed Hospital is affiliated with Sir Syed College of Medical Sciences (for girls). The duration of study was 5 years, from 1st Januay'08 to 31st December 2012. Sampling technique was convenient, non probability.
A proforma was designed to obtain relevant information. Maternal characteristics were similar in grandmultipara(GMP) and low MP. There should be no maternal disease, no antenatal risk factors. The proforma included detailed record of labour management, including progress of labour, operative delivery, third stage complications and fetal outcome.
Results :
Prolonged labour was seen in 19/96(19.8%) GMP vs 5/104(4.81%) low MP (OR: 4.8857).Caesarean sections were seen in 26(27.08%) vs 1/104. (OR: 38.2571) which is statistically significant. Obstructed labour, failure to progress and meconium stained liquor were the main indications for caesarean section. Perinatal mortality was significantly increased in GMP as compared to low MP (OR: 5.5291)
Conclusion: The current study highlights grandmultiparity as a risk factor for prolonged labour,obstructed labour and emergency caesarean section, meconium aspiration syndrome and perinatal mortality.Women need to be informed of the dangers of high order births and advised to confine in tertiary care hospital and to limit their family size by effective contraceptive methods.
Key words: caesarean section high risk pregnancy grandmultiparity intrapartum

Key words: Cesarean section, high risk pregnancy, grandmultiparity, intrapartum



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