Postnatal Maternal Risks among Multiparous Women and its effect on Pregnancy Outcomes
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postnatal maternal complication, Grand multipara, Multipara
Abstract
Background- Pregnancy can be viewed as a developmental stage with its own distinct developmental tasks as well as pregnancy produces marked changes in a woman’s body, and it is accompanied with minor discomfort such as nausea, vomiting, urinary frequency, and fatigue. Sometime the pregnancy is complicated by pathologic processes that are dangerous to the health of the mother and fetus in only 16-20% of cases. However, only limited studies have so far been done to identify the maternal risks in postnatal and it is Impact on Pregnancy Outcomes among Grand-Multiparous Women.
Objective- Identify postnatal maternal risks among multiparous women and its impact on pregnancy outcome.
Methodology- A descriptive, cross sectional study design was utilized. Purposive sample of (200) laboring women which consist two groups 100 multiparous women had (Para2-4) and 100 grand multiparous women had (Para ≥ 5) , who were admitted in three hospitals (Baghdad Teaching Hospital, Al- Yarmook Teaching Hospital, Fatima Al- Zahra’a Maternity and Pediatric Teaching Hospital), during the period from 29 April to 8 August 2010. The data was collected through interview technique and use constructed questionnaire format that consists four parts. The data were collected through face-to-face interview technique and by using questionnaire format. Data were analyzed through the application of descriptive and inferential statistical analysis.
Results- The incidence of postnatal complications among the study sample in (multipara, grandmultipara) as follows: Anemia (20%, 22%) , Cesarean section wound infection (9%,14%) , Early postpartum hemorrhage ( 7%, 10%) , Breast engorgement (6%, 9% ), Postpartum blues ( 5%, 9% ), Delivery canal inflammation ( 3%, 5% ), Stress incontinence ( 3%, 5%), Sub involution of uterus ( 3%,4%), Mastitis (2%,3%), Uterus prolapsed (1%, 9% ), Episiotomy infection ( 2%,1% ), .puriperal sepsis (1%, 2%). In addition there is significant difference in uterine prolapsed (P=0.009) between the (multipara & grandmultipara), while there are no significant differences in the incidence of other postnatal complications among both group. Health status of the majority of neonates for both groups (85%, 82%) were good, their Apgar score was (7-10) in five minute of neonate's life, and most of them did not have congenital anomalies, only 3% in each group had neonate death after delivery. There is a significant relationship in age for both groups and antenatal risks.
Conclusion: The occurrence of postnatal maternal risks is significantly higher in grandmultiparity compared with multiparty.
Recommendations- Importance of providing health awareness for mothers concerning risks associated with postnatal which were increased in subsequence and high pregnancies through educational programs and mass media, and emphasize on nursing role in this field. Improvement and promotion of postnatal health services especially for those risky women.
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