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Created on : 08 Oct 2004
Modified on : 02 Dec 2007

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Bibliographical entry (without author) :

Is grand multiparity an independent predictor of pregnancy risk? A retrospective observational study. Letters. Med J Aust. 2004 Feb 16;180(4):196-7; author reply 197.

Author(s) :

de Costa CM.

Year of publication :

2004

URL(s) :

http://www.mja.com.au/public/issues/180_04_160204/…

Résumé (français)  :

En réponse à l’article de Humphreys MD, fiche 506.

Abstract (English)  :

To the Editor: As a “grand multip” myself, I turned with interest to Humphrey’s recently published study of grand multiparity and pregnancy risk at Cairns Base Hospital.1 However, I cannot support his conclusions.

Throughout the period of the study, most grand multiparous women giving birth at this hospital were actively managed in the third stage of labour with a regimen designed to prevent postpartum haemorrhage (intravenous ergometrine/oxytocin). Women of lesser parity were also given preventive therapy, but generally in lower doses and less consistently. This is a major confounding factor not addressed in Humphrey’s study. Clearly, an unknown, but probably significant, number of haemorrhages were prevented by this treatment.

….

What is clear from these data is that grand multiparous women in far north Queensland are often economically and socially disadvantaged compared with women of lower parity. This is a common finding in almost all studies of grand multiparity. 2,3,5 We should remember that these women are taking home a new baby to conditions that may already be quite compromised. They deserve the best obstetric care we can offer them, and we should be very cautious when reviewing protocols that we do not increase risks to these women or their babies.

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Resumen (español)  :

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Argument (français) :

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Keywords :

➡ evidence-based medicine/midwifery ; postpartum hemorrhage

Author of this record :

Cécile Loup — 08 Oct 2004