Obstetric outcome in grand multipara – a Meghalaya experience
Journal Title: The New Indian Journal of OBGYN - Year 2019, Vol 5, Issue 2
Abstract
Objectives: This study was carried out to evaluate the obstetric and perinatal outcomes in grand multipara. Methods: A retrospective descriptive analytical study was carried out in the department of Obstetrics and Gynecology. All the case records of the grand multiparae (> gravida 5) admitted from 1st February 2016 to 28th February 2018 were observed for gravida, parity, age, religion, associated morbidities such as anaemia, pregnancy induced hypertension, gestational diabetes mellitus (GDM), obstetric complications such as post partum hemorrhage and rupture uterus, mode of delivery, neonatal outcome and maternal mortality. Results: Incidence of grand multiparity was 10.75% (571/5308). These 571 cases were from 3 groups: Group I – gravida 5 to 7 (358 = 62.69%), Group II – gravida 8 to 10 (158 = 27.67%) and group III – gravida > 10 (55 = 9.63%). In group I and III all mothers belonged to Christian religion whilst in Group II, 0.35% were from other religions also. In this study the highest gravida was 18 gravida. The range of age was 18 – 48 yrs (Mean age of 33.8 yrs). Incidence of significant anemia (Hb < 8 g/dl), in the three groups were 7.82%, 8.86% and 14.54% respectively. Incidence of pregnancy induced hypertension was 6.98%, 9.49% and 10.90% in the three groups respectively. Incidents of GDM were 1.22% in total with 1.39% in Group I and 1.26% in Group II. Two hundred thirty three (40.80%) deliveries were by lower segment caesarian section. Post partum hemorrhage occurred in 2.51%, 3.16% and 9.09% in group I, II and III respectively. Three patients had rupture of uterus (two belonging to group II and one in group I). There was no maternal mortality. Only 35(6.12%) deliveries resulted in perinatal deaths of which 4.37% (25) were still births. There were no congenital anomalies in the babies. Conclusion: Owing to unique social and religious influences in the hill state of Meghalaya with predominantly tribal population, there is high incidence of grand multiparity. This study concludes that there is no significant increase in incidence of maternal morbidities and mortality with increasing parity in the women of Meghalaya.
Authors and Affiliations
Indrani Roy, Ashish Burande, Richa Choubey
Huge fimbrial cyst causing bilateral hydroureteronephrosis - a rare case report
Small fimbrial cysts are most commonly seen, sometimes become larger and presents with symptoms. Here we presents a case of huge fimbrial cyst detected incidentally in a 20 year nulligravida came to out patient departmen...
Ectopic vaginal ureterocele presenting as vaginal gartner’s cyst
Ureterocele represent the intramural portion of distal ureter. Most of them are associated with the upper moiety ureter of a duplex system and are therefore ectopic and are commonly inserted within the bladder neck. A 23...
Posterior uterine rupture – A devil with many faces
Uterine rupture in an unscarred uterus is a rare occurrence. A 25 years old, multigravida woman with an unscarred uterus who was induced with misoprostol at a primary health center and referred to our facility with provi...
Pregnancy outcome in women with congenital heart disease in a tertiary care centre
Objective: To find out prevalence of congenital heart disease in pregnant women and its cardiac, obstetric and neonatal outcome. Methodology: A prospective study was conducted on 74 mothers who had congenital heart disea...
Myomectomy of incision site uterine fibroid during caesarean section: a case report
Fibroids are common benign smooth muscle tumours occurring in 20-40% of women with an incidence of approximately 0.1% to 12.5% of all pregnancies. A 23 years old primigravida at 38 weeks 5 days gestational age referred f...