Maternal and Fetal Outcome in Grandmultipara - An Observational Study

Abstract Introduction: Maternal and perinatal morbidity and mortality are significant health challenges in developing countries, particularly India, where over 99% of maternal deaths occur. Among various risk factors, grand multiparity, defined by the World Health Organization (WHO) as having five or more previous viable pregnancies beyond 24 weeks, markedly increases the risk of complications during pregnancy, labor, and the postpartum period. Objective: This study aims to analyze maternal and fetal outcomes in grand multiparous pregnancies and to highlight the associated risks and complications. Methods: A descriptive observational prospective study was conducted at the Department of Obstetrics and Gynecology, SMS Medical College, Jaipur, from December 2022 for one year. The study included 210 grand multipara women with live pregnancies over 28 weeks of gestation, meeting specific inclusion and exclusion criteria. Comprehensive examinations and investigations were performed, and data on socio-demographic characteristics, pregnancy complications, delivery methods, and fetal outcomes were collected. Results: The mean age of participants was 33.78 ± 3.03 years, with a predominance of women. Complications were prevalent, with anemia (60%) being the most common. Postpartum complications occurred in 11.4% of cases, with uterine atony as the predominant cause of postpartum hemorrhage. Among newborns, 69.5% scored greater than 7 on the APGAR scale at 1 minute, while 90.4% scored above 7 at 5 minutes. Notably, 9.52% of newborns required NICU admission, primarily due to prematurity. Conclusion: Grand multiparity is associated with significant obstetric risks, hence Comprehensive antenatal care and regular monitoring are crucial for improving maternal and fetal outcomes in affected populations.