Downloaded 58 times
Uploaded bySREEVIDYA UMMADISETTI
ELDERLY PRIMI GRAVIDA & GRAND MULTI PARApptx
DESCRIBES ABOUT ELDERLY PRIMI GRAVIDA AND GRAND MULTI PARA
More Related Content
Similar to ELDERLY PRIMI GRAVIDA & GRAND MULTI PARApptx
![Grand multiparity hi[12915]](https://cdn.slidesharecdn.com/ss_thumbnails/grandmultiparityhi12915-210509123619-thumbnail.jpg?width=640&height=640&fit=bounds)
More from SREEVIDYA UMMADISETTI
ELDERLY PRIMI GRAVIDA & GRAND MULTI PARApptx
- 1.
- 2. INTRODUCTION The elderly primigravidais a woman going through her 1st pregnancy at or over the age of 35years.This definition may be adopted in the developing countries, but it must be remembered that the reproductive activity of the women in developing countries starts at a much earlier age than that of the women in developed countries. Although the age limit is being raised from 35-40 years in India, Britain and other European countries , it may be wise to regard as an elderly primigravida, any women who is pregnant for the 1st time at the age of 30years or more is elderly primi gravida.
- 3. DEFINITION 1. Women havingtheir first pregnancy at or above the age of 30 years called elderly primigravidae. 2. Waters and Wager1 coined the term "elderly primigravida" to describe a woman who is 35 years of age or older and pregnant for the first time.
- 4. CATEGORIES: Elderly primigravidae are divided into two categories; 1. High Fecundity: A woman married late but conceives soon after marriage 2. Low Fecundity: Woman married early but conceives long after marriage
- 5.
- 6. DURING PREGNANCY 1. Abortion 2.Pre-eclampsia associated with hypertension 3. Abruptio placenta- due to pre-eclampsia and folic acid deficiency 4. Uterine fibroid 5. Medical complications such as Hypertension (P.I.H), Diabetes Mellitus and Organic Heart Disease 6. Post maturity 7. Intra-uterine growth restriction (IUGR)
- 7. DURING LABOUR 1. Premature labour 2. Prolonged labour 3. Maternal and foetal distress 4. Increased operative interference 5. Retained placenta
- 8. DURING PUERPERIUM 1. Increasedmorbidity due to operative interference 2. Failing lactation
- 9. MANAGEMENT i. The motheris considered as “ High Risk Pregnancy” ii. Meticulous antenatal supervision is needed iii. Labor is usually longer in elderly primigravida than in the multipara iv. Posterior positions of the occiput are very common. v. Abnormal uterine action may complicate labour vi. Elderly primigravidae requires obstetric intervention because of the rigid perineum and prolonged labour. vii. The neonatal morbidity and mortality are increased because of prematurity, prolonged labour, increased risk of congenital anomalies like (Mangolism, hydrocephalus, anencephaly etc..).This is all due to increasing maternal age.
- 10. Cont. viii.There should bea hospital delivery ix. If induction is unsatisfactory, cesarean section is done x. Sonography is done to detect bony malformation of the fetus, if it is, then only LSCS is done xi. Check for additional complications
- 11.
- 12. INTRODUCTION A grand multipararelates to a pregnant mother who has got previous four or more viable births. The incidence has been gradually declining over the couple of decades due to acceptance of small family norm, but it still constitutes to about one-tenth of the hospital population and accounts for one-third of the maternal deaths in the developing countries.
- 13. DEFINITION 1. A grandmultipara relates to a pregnant mother who has got previous four or more viable births. -D.C.Dutta 2. A grand multipara is a pregnant woman who has got previous four or more viable births. - Dr. Shally Magon
- 14.
- 15. DURING PREGNANCY 1. Abortion 2.Obstetric hazards like Mal presentation Multiple pregnancy Placenta previa 3. Medical Disorders i.e., Anaemia Hypertension Cardio vascular complications 4. Pre maturity
- 16. DURING LABOUR 1. Cordprolapse 2. Cephalo pelvic disproportion (CPD) 3. Obstructed labour 4. Rupture uterus 5. Postpartum hemorrhage 6. Shock 7. Operative interference 8. Precipitate labour
- 17. DURING PUERPERIUM 1. Increasedmorbidity due to intranatal hazards 2. Sub involution 3. Failing lactation
- 18. MANAGEMENT 1. The casesare considered as “high risk”. As such they require adequate antenatal care and should have a mandatory hospital delivery. 2. During labor, the following guidelines are prescribed— Pelvic assessment should be done as a routine Presentation and position are to be checked Undue delay in progress should be viewed with concern To remain vigilant against PPH
- 19. Cont. 3. Facilities fordealing with complicated deliveries They require adequate antenatal care Delivery should be done routinely Monitoring of vital parameters including pain Check foetal presentation and position Monitoring of further complications of both the mother and the baby