A grand multipara is defined as a woman who has had four or more previous viable births. Such women face increased risks during pregnancy, labor, and the postpartum period, including abortion, malpresentation, prematurity, cord prolapse, obstructed labor, rupture of the uterus, and postpartum hemorrhage. Due to these complications, grand multiparas have a higher rate of maternal mortality in developing countries. As high-risk patients, grand multiparas require close antenatal monitoring and hospital delivery to watch for issues like abnormal fetal positioning, slow labor progression, and postpartum bleeding.
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This ppt is made by Mr. arkab khan pathan under guidance of Mrs. RAKHI GOAR. this ppt contain the detail and all the lecture notes of HEG.
THANK YOU.
Arkab khan
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Hydatidiform Mole (HM) is a rare mass or growth that forms inside the uterus at the beginning of a pregnancy. It is a type of gestational trophoblastic disease (GTD).
When a normal sperm cell fertilizes one of these oocytes, the resulting embryo has only one set of chromosomes. Because the embryo has no genes from the mother, the pregnancy cannot develop normally, resulting in a hydatidiform mole.
Introduction
Screening of high risk cases
High risk cases (according to WHO)
Management of high risk cases
Risk approach (according to WHO)
Interventions to reduce maternal mortality
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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
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.
