grand multipara

1. GRAND MULTIPARA
Prepared by-
JOISY S JOY
Lecturer
Mai Khadija Institute of Nursing Sciences, Jodhpur.

2. Definition
A grand multipara relates to a pregnant mother who has got previous
mother who has got previous four or more viable births.

3. Incidence
 The incidence has been gradually declining over the couple of decades
due to acceptance about one-tenth of the hospital populations and
accounts for 1/3 of the maternal death in the developing countries.

4. Complications
Pregnancy
 Abortion
 Inherent obstetric hazards like;
• Malpresentation
• Multiple pregnancy
• Placenta praevia
 Medical disorders such as anaemia hypertension, haemorrhoids and
varicose veins etc.
 Prematurity

5. Labour
 Cord prolapse
 Cephalopelvic disorders
 Obstructed labour
 Rupture uterus
 Post partum haemorrhage
 Shock
 Operative interference because of complications

6. Puerperium
 Increased morbidity due to intranatal hazards
 Sub involution
 Failing lactation

7. Management
The cases are considered as ‘high risk’ as such they require adequate
antenatal care and should have a mandatory hospital delivery. During, the
following guidelines are prescribed.
 Pelvic assessment should be done as a routine.
 Presentations and positions are to be checked
 Undue delay in progress should be viewed with concern.
 To remain vigilant against PPH.

8. THANK YOU