TITLE:
Grandmultiparity: Incidence, consequences and outcome in the Niger delta of Nigeria
AUTHORS:
Azubuike Ikechukwu Joseph, Ibrahim Isa Ayuba, Israel Jeremiah
KEYWORDS:
Grandmultiparity; Outcome; Incidence; Niger Delta
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.3 No.7,
August
13,
2013
ABSTRACT: Sub-Saharan Africa has the highest rates of maternal and neonatal mortality worldwide. Grandmultiparity has been traditionally considered as a risk factor for adverse pregnancy outcome. The aim of this study is to determine the incidence, neonatal and maternal outcome of pregnancy in grandmultiparous women. This is a retrospective cross sectional study of grandmultiparous patients that were managed at the University of Port Harcourt Teaching Hospital, Rivers State, Nigeria, from 1st April 2007 to 31st March 2009. There were a total of 6760 deliveries during the study period, out of which 130 were grandmultiparous giving an incidence of 1.92%. Their mean age was 35.99 years and mean parity 5.70. Most of the patients 62 (47.5%) were para 5. About 71 (54.5%) had seconddary education, while 30 (22.8%) had tertiary level of education, 93 (71.3%) were Booked, while 37 (28.7%) were unbooked. Hypertension, malaria, antepartum haemorrhage, diabetes mellitus, anaemia and abnormal lie and presentation occurred in 68 (52.6%) during the Antenatal period with some patients having more than one complication. Labour complications occurred in 25 (19.0%) of the patients and 36 (27.4%) had anaemia at delivery. 80 (61.4%) achieved vaginal delivery. The caesarean section rate was 34.7%, and 74.3% were performed as emergency procedure. The blood transfusion rate was 12%. The maternal mortality ratio was 1538.46/100,000 live births and the perinatal mortality rate was 107.69/1000 births. It was concluded that the incidence of Grandmultiparity is low in our center compared to other centres in Nigeria, however, they tend to have unfavorable obstetric outcome. Concrete measures must be put in place to address these through specialized antenatal care and adequate management of Unbooked Emergencies.