Cesarean section in grandmultiparas.

Grandmultiparity which has been considered to be a factor in maternal and neonatal morbidity [3], is still high in Libya as compared with European countries. A retrospective study of one aspect of this problem concerned the Cesarean section in patients who had delivered 6 or more babies. During the period of January Ist to the end of December 1993, the records of all grandmultiparous women who delivered by a Cesarean section (287 cases) were reviewed at Obstetric Department of University Hospital in Benghazi-Libya. The incidence was 7.9%. The most common indications for the Cesarean section were: fetopelvic disproportion or failure to progress (26.5%), previous Cesarean sections (19.5%), malpresentation (16%), placenta praevia and failed induction for each of them (7%). The perinatal mortality was 17/1000. We conclude that grandmultiparas require Cesarean sections more frequently than nongrandmultiparas, especially primary and emergency Cesarean sections. For such patients an effective family planning program is necessary.