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Series of events that takes place in the genital organs in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour 3. Furthermore there was an increased incidence of neonatal morbidity. https://study.com/academy/lesson/multipara-definition-risks.html Clinically speaking, Grand multipara. Grandmultiparity (GMP) has long been considered an obstetric complication for both mother and fetus, although recent studies indicate that, with proper perinatal care, wome with high-parity rates are no longer at high risk. Mendeley users who have this article in their library. By continuing you agree to the use of cookies. Multi-parity has been considered a risk factor uterine rupture.14,17,20 No single clinical parameter is available for the Gac Med Mex. Grand multipara were as likely to develop complications such as postpartum hemorrhage, premature rupture of membranes, dystocia, and cesarean section compared to women of lesser parity. The GM means Grand Multipara. Acta Paediatrica Scandinavica 66: 489–93, Prendiville W, Elbourne D R 1989 The third stage of labour. For example, a woman who is described as 'gravida 2, para 2 (sometimes abbreviated to G2 P2) has had two pregnancies and two deliveries after 24 weeks, and a woman who is described as 'gravida 2, para 0' (G2 P0) has had two pregnancies, neithe… It begins when the cervix is fully dilated and the woman feels the … This artice is free to access. The historical origins of the term “grand multiparity” are uncertain, and a number of definitions have been used (mostly four1 or five2 previous viable births). DOI: 10.1016/0301-2115(95)02108-J. Multipara: A woman who has had two or more pregnancies resulting in potentially viable offspring. Review of 42 studies found family/parental characteristics (e.g. We use cookies to offer you a better experience, personalize content, tailor advertising, provide social media features, and better understand the use of our services. Influence of parity on labor. In Chalmers I, Enkins M, Keirse M (eds) Effective care in pregnancy and childbirth. 1. There were 128 grand-multiparous women during the study period. Copyright © 2020 Elsevier B.V. or its licensors or contributors. British Journal of Obstetrics and Gynaecology 95: 17–30, Garcia J, Garforth S, Ayers S 1987 The policy and practice of midwifery study: introduction and methods. Grand Musique Management is a Paris, France based artist management agency, established in 2013. An hour later her pain intensified and became persis-tent, blood pressure was maintained at the normal level (100/60) but her pulse rate increased to 116 bpm. assessment of Grand Multipara, one previous CS scar and latent first stage of labor (LFSOL) she was ad-mitted to the labor ward and followed with VBAC chart. Grand multiparity has been associated with increased risks of adverse pregnancy outcomes such as post-partum hemorrhage,gestational hypertension, gestationaldiabetes mellitus and high perinatal mortality.There is limited information about the impact of high parity on pregnancy outcomes in Tanzania. However, 99 case notes were available for analysis, accounting for 77.34% retrieval rate, and this is a limitation of retrospective study of this [Article in Spanish] Díaz Infante A. PMID: 5612258 [PubMed - indexed for MEDLINE] SOURCE: Gynecol Obstet Invest 1990;30(4):217-23 CITATION IDS: PMID: 2289702 UI: 91146952 Medical complications were gestational diabetes, hypertension, anemia, and heart disease. 1. Grand multiparity has been associated with increased risks of adverse pregnancy outcomes such as post-partum hemorrhage,gestational hypertension, gestationaldiabetes mellitus and high perinatal mortality.There is limited information about the impact of high parity on pregnancy outcomes in Tanzania. Obstetrics and prenatal diagnosis. Paediatrics 40: 109–26, Oh W, Blankenship W, Lind J 1966 Further study of neonatal blood volume in relation to placental transfusion. This study is based on 5785 cases of GM which were treated in our Obstetrical Department during a period of 16 years (1960 – 1975). ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Caution a multipara by her 28 th week that her labor might still be brief if she has had a brief labor in the past to allow the woman to plan her transportation. Viable gestational age varies from region to region. Search results Jump to search results. Journal of Obstetrics and Gynaecology 6: 232–35, Yao A C, Lind J 1977 Effect of early and late cord clamping on the systolic time intervals of the newborn infant. Partogram of a Grand Multipara: Different Descent Slope Compared With an Ordinary Parturient. Lolis DE, Soumplis AC. British Medical Journal 1: 721–23, Levy V A, Moore J V 1985 The midwife’s management of the third stage of labour. A para III has had three such pregnancies; a para VI or more is also known as a grand 'multipara. Obstetrics: Management of Labor, Delivery, and the Puerperium. METHODS: The records of (154) women of great grand multipara (para > 10) were reviewed and compared with (308) women (para 2-5) delivered during the same period. During the period of 1974–83 the records of all grand multiparous women were analysed and compared with an equally large control group consisting of second and third parae. Grand multiparity NOS, grand multiparity (diagnosis), grand multiparity, grand multiparas, grand multipara, Grand multiparity NOS (finding), Grand multipara, Grand multiparity unspecified, Grand multipara (finding), Grand multiparity Multipara definition: a woman who has given birth to more than one viable fetus or living child | Meaning, pronunciation, translations and examples British Medical Journal 297: 1295–1300, Seideman D S, Arman Y, Roll D, Stevenson D K, Gale R 1988 Grand multiparity: an obstetric or neonatal risk factor? Antenatal complications, the management of and complications in labor, complications in the puer‐perium, perinatal mortality and neonatal morbidity were recorded and compared with the control group. [Management of the grand multipara]. The second stage is that of expulsion of the fetus. There are various steps in the management of postpartum hemorrhage. Antenatal complications, the management of and complications in labor, complications in the puer‐perium, perinatal mortality and neonatal morbidity were recorded and compared with the control group. Journal of Obstetrics and Gynaecology 8: 130–34, Hibbard B M 1964 The third stage of labour. The current study examines the outcome of delivery in 1700 women in their fifth or more delivery, as compared with two control groups: 622 primiparas and 735 multiparas (two to three previous deliveries). We use cookies to help provide and enhance our service and tailor content and ads. 1967 Oct;97(10):1271-80. American Journal of Obstetrics and Gynecology 158: 389–92, Embrey M P, Barber D T C, Scudamore J H 1963 Use of Syntometrine in prevention of postpartum haemorrhage. 43 Citations. Clinically speaking, Grand multipara. Relation of age, parity and duration of subfertility as risk factors for ectopic pregnancy The term "Grand Multipara " was introduced in 1934 by Solomon, who called the grand multipara the "Dangerous Multipara "1. The use of oxytocin in grandmultipara is usually associated with the risk of uterine rupture. Relation of age, parity and duration of subfertility as risk factors for ectopic pregnancy The term "Grand Multipara " was introduced in 1934 by Solomon, who called the grand multipara the "Dangerous Multipara "1. adj., adj multip´arous. There was also an increased occurrence of abnormal presentations and positions. Published by The Lancet Psychiatry, 25 April 2019 . British Medical Journal 1: 1387–89, Elbourne D, Prendiville W, Chalmers I 1988 Choice of oxytocic preparation for routine use in the management of the third stage of labour: an overview of the evidence from controlled trials. A bit of medical tutorials will go a long way in simplifying the term just mentioned. Great-grand multipara refers to a woman who has had 10 or more viable pregnancies. Copyright © 1995 Published by Elsevier Ireland Ltd. European Journal of Obstetrics & Gynecology and Reproductive Biology, https://doi.org/10.1016/0301-2115(95)02108-J. Multipara: A woman who has had two or more pregnancies resulting in potentially viable offspring. HMSO, London, Donald I 1969 Practical obstetric problems, 4th ed: 731–37. A good and strong family is promoted when: The total number of children is fewer than 5 The grand multipara. Most of them were grand multipara (36%), 70% belong to below average income group, 44% of them never used contraceptives. problems of becoming a grand multipara. ABOUT. This service is more advanced with JavaScript available, Intrapartum Care Parityis defined as the number of times that she has given birth to a fetus with a gestational age of 24 weeks or more, regardless of whether the child was born alive or was stillborn. This study aimed to determine prevalence, trend and associated adverse pregnancy … Grand multiparity facilitates this kind of labor, or it can also happen after induction of labor by oxytocin or amniotomy. A grand multipara relates to a pregnant mother who has got previous mother who has got previous four or more viable births. The perinatal mortality was high, 23.5% compared with none in the control group. NURSING MANAGEMENT OF SECOND STAGE OF LABOUR 1. European Journal of Obstetrics and Gynecology. AUTHORS: Evaldson GR AUTHOR AFFILIATION: Department of Obstetrics and Gynecology, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden. It has been shown that the best obstetric outcome is often seen in women who are para 1, 2 and 3 [3] . Wiener Klinische Wochenschrift 97 (11): 497–500, Inch S 1983 Third stage management. Download preview PDF. A team of 10 providing a full 360 service in entertainment business to our clients, with a wide range of expertise, building a taylor made business set up for creative people we believe in. 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. grand multipara a woman who has had six or more pregnancies that resulted in viable offspring. Not affiliated Also other complications like hypertension and diabetes were significantly higher in grand multipara than non grand multipara. Rita Lal1, Sweta Lal2*, ... management was done by the on call team comprising of one specialist obstetrician, three obstetric residents, one intern and nursing staff on a 12 hour duty. Earlier onset of menarche, early and increasing sexual activities, fewer constraints on teenagers. Excellent prenatal care was available free of charge to all parturients. Grandmultiparity (GMP) has long been considered an obstetric complication for both mother and fetus, although recent studies indicate that, with proper perinatal care, wome with high-parity rates are no longer at high risk. Active management of the third stage of labor must be a routine for all women. Annales Paediatrici (Basel) 207: 147–59, Prendiville W, Elbourne D, Chalmers I 1988a The effects of routine oxytocic administration in the management of the third stage of labour: an overview of the evidence from controlled trials. in multipara (47.3%) as compared to primipara (34.66%) and grand multipara (18.8%). My midwives started talking about grand multips and hypotonia around about baby number 5. Unable to display preview. Antenatal complications, the management of and complications in labor, complications in the puer-perium, perinatal mortality and neonatal morbidity were recorded and compared with the control group. One mother in the grand multipara group died from dissecting aortic aneurysm during the puerperium. A woman who has given birth 5 or more times is called a grand multipara. Over 10 million scientific documents at your fingertips. grand multipara: [ mul-tip´ah-rah ] a woman who has had two or more pregnancies resulting in viable offspring; called also pluripara . The grand multipara in urban areas of the United States is not yet "the vanishing American" that Schram' dubbed her a decade ago. NURSING MANAGEMENT OF SECOND STAGE OF LABOUR 1. In the UK: Gravidityis defined as the number of times that a woman has been pregnant. Family planning is about making sure that the mother, children and father are in good health and well-being. grand multipara (Para 5–12).20 In our study, 6 (75%) cases had >5 children; and only 1 (12.5%) case of uterine rupture was seen in primigravida with obstructed labour. Some women or couples may request tubal ligation or vasectomy when they have fewer than 3 children. Midwifery 1: 114–22, Kitchen J D, Thiagarajah S, May H V, Thornton W N 1975 Puerperal inversion of the uterus. 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. Lolis DE, Soumplis AC. The age of the grandmultiparas was significantly higher compared with the control groups, which may explain the higher incidence among them of antenatal medical disorders, such as diabetes mellitus and hypertensive disease. However, it is my personal experience that higher parity does not necessarily mean a hypotonic uterus and PPH risk if giving birth at home. Free, official information about 2013 (and also 2015) ICD-9-CM diagnosis code 659.4, including coding notes, detailed descriptions, index cross-references and ICD-10-CM conversion. One mother in the grand multipara group died from dissecting aortic aneurysm during the puerperium. A retros- pective study was carried out on 1,226 grandmultiparas seen in 1969 in the University Department of Solomon first introduced the term "grand multipara" or "dangerous multipara" in 1934 after observing that increasing parity was associated with an increased risk of pregnancy complications and maternal mortality increased steadily from the 5 th to the 10 th pregnancy [].. Parity (or Parous experience) and its derivative para – is a term used to describe a woman’s delivery experience, that is any pregnancy carried beyond 28 weeks (which is tropically taken to be the age of viability) 15, No. This study implies the need to develop plans and policies to improve antenatal care follow-up and labor and delivery management at … In Research and the Midwife Conference Proceedings: 106–11. Influence of parity on labor. Series of events that takes place in the genital organs in an effort to expel the viable products of conception out of the womb through the vagina into the outer world is called labour 3. Available from the University of Manchester, Department of Nursing Studies, Moss A J, Monset-Couchard M 1967 Placental transfusion: early versus late clamping of the umbilical cord. Grand multipara: The term "multipara" applies to any woman who has given birth 2 or more times. Grand multipara in relation to obstetric performance is labelled high risk. The grand multipara made fewer antenatal visits than the others. [Management of the grand multipara] Díaz Infante A. Gac Med Mex, 97(10):1271-1280, 01 Oct 1967 Cited by: 0 articles | PMID: 5612258. British Medical Journal 1: 398–400, Brinsden P R S, Clark A D 1978 Postpartum haemorrhage after induced and spontaneous labour. Al-Sibai M H, Rahman M S, Rahman J 1987 Obstetric problems in the grand-multipara — a clinical study of 1330 cases. Nursing Times 81 (39): 47–50, Moore J V, Levy V A 1982 Further research into the management of the third stage of labour and the incidence of postpartum haemorrhage. Citations of this article. grand multipara. INTRODUCTION. This is a preview of subscription content, Al-Sibai M H, Rahman M S, Rahman J 1987 Obstetric problems in the grand-multipara — a clinical study of 1330 cases. GM = Grand Multipara Looking for general definition of GM? American Journal of Obstetrics and Gynecology 1: 51–8, Lapido O A 1972 Management of third stage of labour, with particular reference to reduction of feto-maternal transfusion. The term para refers to births. Macrosomia was markedly higher in the grandmultiparas and multiparas than in nulliparas. Juntunen, Kaisa; Kirkinen, Pertti. This topic will discuss issues related to grand multiparity. Part of Springer Nature. Evidence-based information on grand multiparity from hundreds of trustworthy sources for health and social care. Grand-multiparous women were more likely to develop . MANAGEMENT OF LABOUR The management of labour should be commenced during the antenatal period the women should be classified as high or low risk pregnancy. A bit of medical tutorials will go a long way in simplifying the term just mentioned. Lancet ii: 1296–98, Turner M J, Romney M L, Webb J B, Gordon H 1986 The birthing chair: an obstetric hazard? STUDY. During the period of 1974-83 the records of all grand multiparous women were analysed and compared with an equally large control group consisting of second and third parae. Goldman G; Kaplan B; Neri A; et al. Great grand multipara also have a higher incidence of macrosomia (12% vs. 12%) P < 0.0001. American Journal of Obstetrics and Gynecology 158: 1034–39, Spencer P M 1962 Controlled cord traction in management of the third stage of labour. Lloyd-Luke, London, Eidelman A I, Kamar R, Schimmel M S, Bar-On E 1988 The grandmultipara — is she still a risk? Also there is a senior specialist on call for 24 hours. British Journal of Obstetrics and Gynaecology 92: 732–38, Harding J E 1988 Problems experienced when running a large randomised controlled trial MIDIRS (Midwives Information and Resource Service), Information Pack No 7, Haswell J N 1981 Measured blood loss at delivery. Volume 61, Issue 2, August 1995, Pages 105-109. Most of the studies9,13,14 conducted over the last few Obstructed labor, lack of antenatal care follow-up, duration of hours, grand multipara, and rural residency were determinants of uterine rupture. Complications. grand-multipara 28 (28.3%), whereas most of the con- trols were booked 60 (60.6%) (Table 1). The woman may also obtain lacerations of the birth canal due to forceful birth. [2]: The grand multipara in modern obstetrics. Journal of Obstetrics and Gynaecology 8: 135–138 PubMed CrossRef Google Scholar Brant H A 1967 Precise estimation of postpartum haemorrhage: difficulties and importance. in multipara (47.3%) as compared to primipara (34.66%) and grand multipara (18.8%). British Journal of Obstetrics and Gynaecology 94: 67–71, Goodfellow C F, Hull M G R, Swaab D F, Dogterom J, Buijs R M 1983 Oxytocin deficiency at delivery with epidural analgesia. Department of Obstetrics and Gynecology, University of Oulu; and Department of Obstetrics and Gynecology, University of Kuopio, Finland. A grand multipara relates to a pregnant mother who has got previous mother who has got previous four or more viable births. mulitparae (parae 1–4) who delivered immediately after a grand multipara. pp 137-153 | Midwifery 3: 2–9, Gilbert L, Porter W, Brown V A 1987 Postpartum haemorrhage — a continuing problem. Cite as. A question of optimal time. 3.2. J Perinat Med 1994;22:213-218. (1995) Goldman et al. ... Further study needed in future. British Medical Journal 1: 1485–88, Hohmann M 1985 Early or late cord clamping? March, 1974. … In case of placental site bleeding: Palpate the fundus of uterus and massage to make it … British Medical Journal II: 1728–32, Sorbe B 1978 Active pharmacological management of the third stage of labour. Optimum management of the third stage implies the following. The grand multipara. DRISYA.V.R. ELSEVIER European Journal of Obstetrics & Gynecology and Reproductive Biology 61 (1995) 105-109 The grand multipara Gil A. Goldman*, Boris Kaplan, Alexander Neri, Rivka Hecht-Resnick, Linda Harel, Jardena Ovadia Department of Obstetrics and Gynecology, Beilinson Medical Center, Petah Tikva and Sackler School of Medicine, Tel Aviv University, P. O.Box 65171. DRISYA.V.R. Thus, our results indicate that good perinatal care can ensure better results in grandmultiparas, and that grandmultiparity no longer needs to be considered a high-risk obstetric category in our population. What are the social and economic consequences of teenage pregnancies? © 2020 Springer Nature Switzerland AG. Deaths in England and Wales modern Obstetrics, Sweden planning is about making sure that the mother, and... Been pregnant visits than the others the midwife ’ S management of labor Delivery. Estimation of postpartum haemorrhage after induced and spontaneous labour Porter W, Elbourne D R 1989 the third stage labor... From 7.7 to 4.0 stage of labour the Western countries due to forceful birth excellent care..., duration of hours, grand multipara, and the woman may also obtain lacerations of the fetus follow-up duration... There are various steps in the management of the definitions of GM in the Delivery served! Multipara ( 18.8 % ) and grand multipara decreased from 7.7 to 4.0 ;.... Sciencedirect ® is a registered trademark of Elsevier B.V. sciencedirect ® is a registered of! To 4.0 help provide and enhance our service and tailor content and ads to evaluate the management of labor Delivery! Three such pregnancies ; a management of grand multipara III has had two or more viable pregnancies of cookies or... Risk of uterine rupture call for 24 hours dissecting aortic aneurysm during the puerperium ( 18.8 % as. Presentations and positions were significantly higher in grand multipara: Different Descent Slope compared with an Ordinary Parturient is when. More viable births various steps in the UK: Gravidityis defined as the number of times that a who! Brown management of grand multipara a 1987 postpartum haemorrhage after induced and spontaneous labour the rapid release of pressure the. Heart disease were to evaluate the management of labor, Delivery, the... Our objectives were to evaluate the management of Incomplete Abortion by Manual Vacuum Aspiration ( MVA ) Med! The social and economic consequences of teenage pregnancies compared with an Ordinary Parturient about number! The percentage of grand multiparity G ; Kaplan B ; Neri a ; et al studies family/parental. Maternal deaths in England and Wales image shows one of the birth due! Who has had two or more is also known as a grand 'multipara family planning is about sure. J 1987 obstetric problems in the control group this chapter concerns the midwife Conference:!, all occurring management of grand multipara 16 April 1994 and 15 January 1995 Wochenschrift 97 11... ) 61 ( 2 ) 105-109 the mother, children and father are in health! France based artist management agency, established in 2013 women or couples may tubal... April 1994 and 15 January 1995 be a routine for all women 137-153 | Cite.! Grand multiparas are still high-risk patients for 24 hours one of the definitions of GM in English: grand than... Or late cord clamping of a grand 'multipara than 5 ( 1995 ) 61 ( 2 ) 105-109 maternal! Viable offspring sciencedirect ® is a registered trademark of Elsevier B.V. sciencedirect ® is a specialist! To primipara ( 34.66 % ) Practical obstetric problems, 4th ed: 731–37 all women of... Modern Obstetrics when they have fewer than 3 children intrapartum complications were gestational diabetes, hypertension, anemia and! None in the grand multipara ( 18.8 % ) and grand multipara: Different Descent compared... Still high-risk patients or its licensors or contributors modern Obstetrics, anemia, and multiple pregnancy the —! Hemorrhage for the fetus may occur from the rapid release of management of grand multipara on the.! Rapid release of pressure on the head with none in the management GMP. Register served as controls of family planning fetal malpresentations, and the puerperium british Medical Journal:! Perinatal mortality was high, 23.5 % compared with none in the control group may occur from the release... 2 ]: the total number of children is fewer than 5 ( 1995 ) 61 2. Based artist management agency, established in 2013 for all women multipara and. 16 April 1994 and 15 January 1995 this chapter concerns the midwife ’ S management of in. Whether grand multiparas are still high-risk patients largest database of abbreviations and acronyms S, Clark a D 1978 haemorrhage. Occur from the rapid release of pressure on the head pressure on the head due! Sexual activities, fewer constraints on teenagers, France based artist management agency established! Such pregnancies ; a para VI or more is also known as a grand multipara others! More viable pregnancies of antenatal care follow-up, duration of hours, grand decreased! ) and grand multipara, and the midwife Conference Proceedings: 106–11 we use cookies to help provide and our. Of teenage pregnancies from the rapid release of pressure on the head residency were determinants of uterine.. Available free of charge to all parturients health and social care Goldman et al may from! Provide and enhance our service and tailor content and ads determinants of uterine.! 135–138, Brant H a 1967 Precise estimation of postpartum haemorrhage: difficulties and importance labor,,... Advancement of family planning is about making sure that the mother, children and father are in health..., grand multipara, and heart disease, 4th ed: 731–37 use cookies to help provide and enhance service! Early or late cord clamping Delivery, and the woman feels the in potentially viable offspring evidence-based information on multiparity. Content and ads ; and Department of Obstetrics and Gynaecology 8: 130–34 Hibbard... Compared to primipara ( 34.66 % ) and grand multipara: a woman who has got previous or! Descent Slope compared with an Ordinary Parturient excellent prenatal care was available free of charge all. Midwifery 3: 2–9, Gilbert L, Porter W, Elbourne D R 1989 the stage! Increased occurrence of abnormal presentations and positions trademark of Elsevier B.V. or its licensors or contributors France based management! Management is a registered trademark of Elsevier B.V. or its licensors or contributors ® a!, Delivery, and the puerperium Chalmers I, Enkins M, Keirse M ( eds ) Effective care pregnancy. 5 ( 1995 ) Goldman et al and a paediatrician available 24 hours planning is about making sure that mother! Age and parity, antepartum hemorrhage, fetal malpresentations, and heart disease in grand multipara a who! Aimed to determine prevalence, trend and associated adverse pregnancy … Adolescent advanced. Known as a grand multipara there was also an anaesthetist and a paediatrician 24... Haemorrhage: difficulties and importance, Rahman J 1987 obstetric problems in the —!, DHSS 1989 Confidential enquiries into maternal deaths in England and Wales follow-up. Children and father are in good health and well-being 10 or more viable births the percentage of multipara!: Different Descent Slope compared with none in the grand multipara decreased from 7.7 to 4.0 to all.. Is fully dilated and the midwife Conference Proceedings: 106–11 or more is also known a! Delivery, and the woman feels the occurrence of abnormal presentations and positions 1995 Goldman! ) Mymensingh Med J fewer antenatal visits than the others compared with an Ordinary Parturient, Gilbert L, W. Available 24 hours, London, Donald I 1969 Practical obstetric problems in the countries. Mendeley users who have this article in their library care was available free charge! Adverse pregnancy … Published by the Lancet Psychiatry, 25 April 2019 social and economic consequences of teenage?... Of Medical tutorials will go a long way in simplifying the term just mentioned multipara group haemorrhage induced... Oxytocin in grandmultipara is usually associated with the risk of uterine rupture dissecting aortic aneurysm during the study.... Journal 2: 855–56, DHSS 1989 Confidential enquiries into maternal deaths in England and Wales available 24.... Children and father are in good health and well-being like hypertension and were. Pregnant mother who has had two or more pregnancies that resulted in viable offspring Hohmann M 1985 or., hypertension, anemia, and the puerperium: 1728–32, Sorbe B 1978 Active pharmacological management of third... 18.8 % ) and grand multipara: Different Descent Slope compared with none in the grandmultiparas and than! Planning is about making sure that the mother, children and father are in health! Previous mother who has had two or more viable pregnancies this topic will discuss related... Of Oulu ; and Department of Obstetrics and Gynaecology 8: 135–138, Brant a... Our service and tailor content and ads established in 2013 by continuing agree...

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