BMC Pregnancy Childbirth. Double data was entered using EpiData version 3.02 software. There was a tendency to an increased rate of gestational hypertension, although the incidence of preeclampsia and chronic hypertension was comparable in the 2 groups. The most common complications were hypertensive disorders, anemia, and preterm labor. Murphy. WebAssessment and management of women during postnatal period. Regular monitoring of blood pressure and blood sugar level is done Antenatal ultrasound scan should be offered to detect any abnormalities and asses fetal weight The grand Register your specific details and specific drugs of interest and we will match the information you provide to articles from our extensive database and email PDF copies to you promptly. The overall cumulative incidence of adverse perinatal outcomes was 33% (95% CI: 29.9%, 36.4%). Several features of Activate your 30 day free trialto unlock unlimited reading. It is associated with many medical and obstetrical complications. Hoque M, Hoque E, Kader SB. 45. doi:10.1111/j.1600-0412.2012.01372.x, 34. 2019;126:132. HHS Vulnerability Disclosure, Help Descriptive statistics like frequencies table and summary indices were used to describe the study population. Each adverse birth outcomes percentages of multiparity versus grand multiparity were displayed below in figure details (Figure 1). Both groups were comparable with regard to gestational age at delivery. Ahmed N, Akhter S, Das T. Grand multipara with multiple encounters in a tertiary level hospital of Bangladesh. LOW MULTIPARAE: Low multiparae is woman who has delivered less than five (para 1-4). Epub 2006 Jul 13. Statistical significance was declared when the P-value was less than 0.05. The overall cumulative incidence of adverse perinatal outcomes was 33% (95% CI: 29.9%, 36.4%). Some of the included potential confounding variables were socio-demographic characteristics: maternal age, religion, ethnicity, household wealth status, education of respondents, education of husband and occupation; obstetrics and some medical factors: history of preterm birth, history of stillbirth, and unplanned pregnancy. 12. Figure 1 Adverse perinatal outcomes among grand multiparity (n = 272) and multiparity (n = 544) in selected public hospitals in the Sidama Regional State, Ethiopia 2021. While many of these instances involve first-time childbearing, a significant number include women who have given birth for at least a second time. The current study examines the outcome of delivery in 1700 women in their fifth or more delivery, as compared with two control groups: 622 primiparas and 735 multiparas (two to three previous deliveries). In addition, our thanks go to the Sidama regional health bureau and administrators of all hospitals included in this study for giving us the necessary background information to conduct this study. The controls were selected based on the five age-interval categories and delivered on the same day of the exposure. We have also excluded women with multiple pregnancies, Primigravida, chronic illness related to pregnancy, great grand multiparity (women who give birth more than ten), women who are mentally or critically ill and unable to communicate were excluded from the study because of the adverse perinatal outcome more occurred. Five days of training were given before starting the actual data collection. Before In order to provide our website visitors and registered users with a service tailored to their individual preferences we use cookies to analyse visitor traffic and personalise content. The data collection tools were developed in the English language, then translated into the local language (Amharic) by language experts. 53. Clipboard, Search History, and several other advanced features are temporarily unavailable. Classifying grand multiparous women as a high-risk group without clear evidence of a consistent association with adverse outcomes can lead to socioeconomic burdens to the mother, family and health systems. [2],[3]This is why this study was designed to determine the obstetric performance of booked grand multiparae in our unit, which is in a predominantly Muslim community, in order to assess the current level of our obstetric care in Aminu Kano Teaching Hospital, Kano, Nigeria, and to make recommendations toward reducing the prevalence and improving the fetomaternal outcome among the grand multiparae. The term grand multipara was introduced by Solomon who called grand multiparas as the dangerous multipara1. Grandmultiparity. Grand multiparity: is it still a risk in pregnancy? 36. In addition, those women with grand multiparity who delivered at another facility (outside the included hospitals) were also excluded as it was difficult to know the perinatal outcomes. 2015;65(1):135140. Maternal mortality fell by almost half between 1990 and 2015; 2017. DEFINITION Grand multiparous (GMP) defined as parity 5 with single post-caesarean lower segment uterine scar admitted at a gestational age of 37 completed weeks and Grand multiparity: obstetric performance in Aminu Kano teaching hospital, Kano, Nigeria. Declaration of Helsinki. Adverse perinatal outcomes or complications were defined as the presence of either or more of the following: stillbirth, low birth weight, macrosomia, preterm, admission to neonatal intensive care unit (ICU), and first-minute birth asphyxia in women giving birth more than five or more and less than five births. This finding was comparable to the studies conducted in Ethiopia (19%), Nigeria (25%), and Bangladesh (23%).22,25,50 Also, the finding showed that the risk of preterm birth was higher with grand multiparity. For continuous variables normality distribution was tested applying visual inspection and statistical tests ShapiroWilk tests and we considered as normally distributed if p-value > 0.05. WebGrand Prairie. Placenta previa is one risk associated with advanced maternal age multipara. Lactation management. 972-854-0009. 22 chapters | Slightly more than two-thirds (67.5%) of the multiparous women and (49.6%) of the grand multiparous women were urban dwellers. Therefore, this study aimed to investigate adverse perinatal outcomes of grand multiparity in selected public hospitals in the Sidama Regional State of Ethiopia. Permission was obtained from the Sidama Regional Health Bureau. Abou Zahr C. Global burden of maternal death and disability. - Definition, Symptoms & Treatment, What Is Dyspareunia? Pulse rate 80 bpm and regular. WebManagement of the Grande Multipara Take a careful history past obstetric history Optimise HB and iron stores Increased surveillance and screening in pregnancy 2015;27(4):244. doi:10.5455/msm.2015.27.244-247. A woman considered to be a grand multipara has experienced five or more viable pregnancies lasting longer than 20 weeks. The region is divided into 36 districts (6 urban districts and 30 rural districts) with one Hawassa city administration. In the same regard, a primipara woman who has experienced a full term pregnancy but has given birth to triplets would be described as "gravidity 1 parity 1" because there was a single pregnancy (gravidity) that lasted for more than 20 weeks (parity), regardless of how many children were birthed. This site needs JavaScript to work properly. 2016;5(3):788792. Pregnancy complications were more prevalent among the grand multiparae in this study, probably because of an older maternal age, which predisposed them to medical disorders of pregnancy and abruptio placenta,[2],[3],[4],[5],[6]while high parity predisposed them to anemia, placenta previa, and fetal malpresentations. Disclaimer. Mid-Upper Arm Circumference (MUAC), body mass index, and sex of the newborn. Contact Us WHO report. 2016;34(4):184187. 2015;131:E445. A pregnancy is classified as viable when it has lasted for 20 weeks or longer. john wiley & sons; 2013. Our objectives were to evaluate the management of GMP in contemporary obstetrics and to assess whether grand multiparas are still high-risk patients. In different studies conducted in developing countries, adverse perinatal outcomes are significantly associated with grand multiparity compared with multiparity.1,4,7,10,15,1726 The majority of the studies carried out in developing countries, including Ethiopia, implemented incomplete registration of perinatal data with limited variables. 214-294-6300. There were no instances of uterine rupture or maternal demise. sharing sensitive information, make sure youre on a federal There was no statistically significant difference between the grand multiparous and multiparous women in the body mass index ( Table 1 ). official website and that any information you provide is encrypted Omole-Ohonsi A, Ashimi A. This condition prevents a proper birth and can be harmful to the mother and her child. A woman who has experienced five or more viable pregnancies is known as a grand multipara and a woman with ten or more viable pregnancies lasting beyond 20 weeks is a great-grand multipara. doi:10.21276/obgyn.2019.5.2.8, 14. Solomon first introduced the term "grand multipara" or "dangerous multipara" in 1934 after observing that increasing parity was associated with an increased risk of pregnancy complications and maternal mortality increased steadily from the 5 th to the 10 th pregnancy [].. The mean birth weight of babies born from women with grand multiparity was 3140.3 grams and multiparity was 3165.9 grams among women with grand multiparous than multiparous women (t-test = 0.53, P-value=0.596), but there was no meaningful difference between grand multiparity and multiparity. 46. Our special thanks also go to participants who generously shared their thoughts and feelings despite other commitments. 2017;7(4):438. doi:10.4172/2161-0932.1000438, 23. - Causes, Symptoms & Treatment, What Is Mammography? Al-Farsi YM, Brooks DR, Werler MM, Cabral HJ, Al-Shafaee MA, Wallenburg HC. Pregnancy complications of grandmultiparity at a rural setting of South Africa; 2008. Int J Gynecol Obstet. Out of the 17 hospitals, 5 (30%) hospitals were selected purposively which provided full packages of maternal and newborn services in the region. This is an increasingly rare occurrence in modern society, especially in comparison to child birth rates following World War II. 2015 Aug;27(4):244-7. doi: 10.5455/msm.2015.27.244-247. The Chi-square test for parity and perinatal outcomes is shown in Table 2. 2015;136(4):819822. - Definition, Causes, Symptoms & Treatment, What Is Benign Prostatic Hyperplasia (BPH)? For example, a woman who has become pregnant but loses the pregnancy in a miscarriage before 20 weeks would be noted as "gravidity 1 parity 0." Statistical Methods for Rates and Proportions. The research was submitted to Pan Africa University Life and Earth Sciences Institute, University of Ibadan, and the University of the Ibadan/University College Hospital, Ibadan Ethics Committee for approval (Ethics committee assigned number_/EC/20/0439). Br Med Bull. Pregnancy in grand multiparous women is viewed with anxiety, especially by obstetricians in developing countries working with inadequate facilities. If you agree to our use of cookies and the contents of our Privacy Policy please click 'accept'. Human Anatomy & Physiology: Help and Review, Anatomy and Physiology of Male and Female Reproductive Systems: Help and Review, What Is a Hysterectomy? J OBGYN. The https:// ensures that you are connecting to the WebAbstract. The advantages of using the modified Poisson regression model include improved precision for estimation of relative risk, robustness to omitted covariates. A woman who has had two pregnancies would be considered multigravida, but if only one pregnancy was full-term, she would only be considered primipara and noted as "gravidity 2" (two pregnancies) "parity 1" (only one pregnancy lasting beyond 20 weeks). 11. Unauthorized use of these marks is strictly prohibited. This finding is similar to the study conducted in Tanzania.7 In some research reports in Jordan, preterm delivery is not associated with grand multiparity.30 The possible explanation might be women get good quality of modern medical and obstetrics services as well they have adequate knowledge on maternal and child health.30, The finding revealed that the risk of stillbirth was higher with grand multiparity. Tabular List. If a woman reaches ten or more viable pregnancies lasting beyond 20 weeks, she is then considered a great-grand multipara. 28. A nurse has administered Methergine (methylergonovine) 0.2 mg po to a grand multipara who delivered vaginally 30 minutes earlier. 3095 Kingswood Blvd. Babinszki A, Kerenyi T, Torok O, Grazi V, Lapinski RH, Berkowitz RL. [2],[3]Despite the government's population policies which favor the small family size,[7]high parity still remains a common feature of our obstetric practice in developing countries,[1],[2],[3],[4],[5],[6]with an overall incidence of 10-30%, with higher rates in the Muslim countries, where there is a large-family norm and poor acceptance of family planning methods. Nevertheless, grand multiparty might not be discouraged as long as women are provided with good perinatal care. Privacy Policy The International Statistical Classification of Diseases and Health Related Problems ICD-10: Tenth Revision. Mgaya AH, Massawe SN, Kidanto HL, Mgaya HN. 972-854-0009. WebEffect of Grand Multiparity on Obstetric and Neonatal Outcome in University of Ilorin Teaching Hospital, Ilorin In the final model, multivariable Poisson regression analysis was performed to investigate the risk factors between grand multiparity and concerned adverse perinatal outcomes. 41. 2020;15(8):e0236965. The source of funding to carry out this research was from Pan African University of Life andEarth Sciences Institute, Pan African University, African Union. Volume 2022:14 Pages 363372, Editor who approved publication: A woman who has become pregnant two or more times is considered multigravida, and if those pregnancies last beyond 20 weeks each, the woman will be classified as multipara. 2018;5(5):104172. Grandmultiparity (GMP) has long been considered an obstetric complication for both mother and fetus, although recent studies indicate that, with proper perinatal care, The age of the grandmultiparas was significantly higher compared with with the control groups, which may explain the higher incidence among them of antenatal medical disorders, such as diabetes mellitus and hypertensive disease. Grand multiparity (GMP) was defined in the older literature as giving birth seven times or higher [].More recent reports describe it as parity of five or more [].With the widespread application of family planning in developed countries, GMP has decreased in Western society and its prevalence became very low (~4% of all births) [].In many parts of Niger J Clin Pract. Med Arch. Our appreciation also goes to data collectors and supervisors for their diligence during data collection to obtain necessary information. 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