Elderly Primigravida and Grand Multipara Flashcards
(20 cards)
Who is an elderly primigravida?
A woman whose first pregnancy occurs at age 35 or older at the estimated date of delivery.
Define grand multipara.
A woman who has carried five or more pregnancies to viability.
What is the significance of elderly primigravida and grand multipara in obstetrics?
They are considered high-risk obstetric cases with increased maternal and fetal morbidity/mortality.
List two reasons for the increasing incidence of elderly primigravidas.
Increased availability of assisted reproductive technologies; delayed marriage or childbirth for career.
What is the incidence of elderly primigravida in Nigeria?
Approximately 2.6%.
List two preconception problems associated with elderly primigravidas.
Difficulty conceiving; may require assisted reproductive technology.
Name three pregnancy-related complications in elderly primigravidas.
Miscarriages, chromosomal abnormalities, gestational diabetes, hypertension, post-term pregnancy.
What are three labour and delivery problems in elderly primigravidas?
Premature labour, poor progress in labour, increased caesarean rate.
State the management principles for elderly primigravida.
Good antenatal care, monitor for medical issues, support in labour, prompt augmentation if needed.
Who first used the term “Grand multipara”?
Solomons B in 1934, in The Lancet.
What is the highest number of children recorded from one woman?
69 children – by the wife of Feodor Vassilyev (Russia), through 27 pregnancies.
State three causes of increased maternal risk in grand multiparas.
Wear and tear from previous pregnancies, increased maternal age, socio-economic challenges.
How does “pregnancy wear and tear” affect the uterus?
Myometrial thinning, fibrosis (→ dysfunctional labour), and endometrial thinning (→ PPH, retained placenta).
What long-term effects can occur due to repeated pregnancies?
Uterine prolapse, stress urinary incontinence, pelvic floor dysfunction.
List any three pregnancy-related complications in grand multipara.
Anaemia, preeclampsia, placenta praevia, malpresentation, diabetes.
What are three labour/delivery complications in grand multipara?
Obstructed labour, uterine inertia, uterine rupture, increased instrumental/CS rate.
Name two postpartum complications in grand multiparas.
Postpartum haemorrhage, uterine prolapse, stress incontinence.
What is the management plan for a grand multipara?
Supplementation, labour preparedness, vigilant intrapartum care, postpartum follow-up.
List two components of prevention strategies for grand multiparity.
Quality antenatal care, hospital delivery, female education, family planning.
How does increasing maternal age affect miscarriage risk?
Miscarriage risk rises from 1:10 at age 20 to 1:3 by age 40.
