Grand multiparity - a continuing threat: a 6-year review

Review of pregnancy and labour in 1005 grand multiparas who delivered during the 6-year period 1968 to 1973 disclosed an increase in frequency of many of the complications of pregnancy, particularly antepartum hemorrhage, hypertensive disorders and malpresentations. Almost one quarter of the patients received little or no antenatal care. The incidence of low birth-weight and stillbirth was significantly higher in the infants of the patients who had received no antenatal care. Comparison with the total hospital population showed that the perinatal mortality was almost doubled and the maternal mortality was increased 10-fold. The findings suggest that in modern obstetric practice the grand multipara continues to be a high-risk patient from both a maternal and fetal standpoint and that this has important clinical implications.