Maternal Antepartum and Intrapartum Complications Among Grand Multiparous Women in a Tertiary Hospital

Open Access

Abstract

Background: Grand multiparity, defined as five or more previous viable pregnancies, is associated with an increased burden of antepartum and intrapartum complications, including anaemia, hypertensive disorders, malpresentation and obstructed or prolonged labour, which together contribute substantially to maternal morbidity in resource-limited settings. Objective: To determine the pattern and frequency of antepartum and intrapartum complications, together with the resulting mode of delivery and postpartum course, among grand multiparous women managed at a tertiary care hospital. Methods & Materials: This cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology, Kushtia Medical College Hospital, Kushtia, over six months from December 2019 to May 2020. Fifty grand multiparous women meeting predefined inclusion and exclusion criteria were enrolled by purposive sampling and assessed through a structured interview and hospital record review. Data were analyzed using SPSS version 22.0, with p<0.05 considered statistically significant. Results: Anaemia was the commonest antepartum complication (90.0%), followed by pre-eclampsia and gestational diabetes mellitus (14.0% each), oligohydramnios (10.0%) and preterm labour (8.0%). Prolonged labour was the leading intrapartum complication (20.0%), followed by malpresentation (10.0%) and obstructed labour and cord prolapse (8.0% each); ruptured uterus occurred in 4.0% of women. Caesarean section was performed in 40.0% of deliveries and assisted vaginal delivery in 6.0%. Postpartum haemorrhage was the leading postpartum complication (8.0%) and maternal mortality occurred in 4.0% of women. Conclusion: Grand multiparous women in this setting carried a substantial burden of antepartum and intrapartum complications, translating into an elevated caesarean section rate and measurable postpartum morbidity and mortality. These findings support intensified antepartum and intrapartum monitoring for this high-risk group.