Obstetric outcome of the grandmultipara in Jos, Nigeria

Grandmultiparity has been, and still is, a source of apprehension to the practicing obstetrician when she presents in labour. The relative prevalence may appear to be declining in other parts of the world, but it still remains a significant contributor of maternal and foetal morbidity and mortality in this part of the world. The study was set out to determine the incidence of grandmultiparity in Jos, North-Central Nigeria. The review of all pregnant women delivering in the maternity unit of the Jos University Teaching Hospital revealed that 19.3% were grandmultipara. The grandmultipara were of age between age 19 and 50 years with a mean age of 32.6 ± 5.3 years. The parity was from 5 to 13 with a mean of 6.2 ± 1.6. Maternal morbidity included increased caesarean section rate (14.6%) and postpartum haemorrhage (11.3%). Twinning rate was also higher (3.2%) for the grandmultipara compared with that for the general population (2.3%) at the time of the study. The maternal mortality rate of 1,226 per 100,000 deliveries was also higher than that of the population (1,047 per 100,000 deliveries). Foetal complications included lower mean birth weight (3.0 kg), and higher stillbirth rate (5.8%) compared to the general population with 3.1 kg and 3.3% respectively. Grandmultiparity is associated with increased risk to the mother and the infant. There is therefore the need for increased patient information on the dangers of grandmultiparity in the population to address the problem. More effort need to be placed on counselling about family planning, delayed marriage and commencement of childbirth. Keywords: grandmultipara, delivery, morbidity, mortality, Jos Nigeria Journal of Medicine in the Tropics Vol. 7(1) 2005: 14-2