الفهرس 
الملخص العربىOnly 14 pages are availabe for public view
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Abstract
Grand grand multiparity is associated with many complications to both mother and fetus. These might occur during the period of the ante, intra and post partrum period. So, the aim of this study consists of two folds; 1- To evaluate the maternal and neonatal morbidity and mortality in the grand grand multiparous women and 2¬To examine the effects of planned nursing intervention on the maternal and neonatal morbidity and mortality. Total of the 460 pregnant women were recruited in the study. 400 pregnant women were subdivided into four groups according to their parity primigravidea, multipara, grand multipara and grand grand multripara (assessment group). While 60 of the pregnant women were grand grand multiparity (intervention group). The methods of data collection were interviewing questionnaire Partograph and Apgar scores. Results revealed that the mean age was 21.9 ± 3.6, 28 ± 4.4, 35.i ± 4.2, 40.1 ± 2.7, 37.8 ± 3.4 in the primigravide ..• , multipara, grand multipara, and grand grand multipara (assessment and intervention groups), respectively. On the other hand, the higher rate of cesarean section 31 % and 46.7% was observed in the grand grand multiparity (assessment and intervention groups, respectively). Also, there were statistically significant differences between the two groups regarding to induction, cesarean section, and post term delivery. The rate of post partum hemorrhage was 5%, 8% in the intervention and assessment groups, respectively .. Mean Apgar score at the first . minutes and fifth minutes in the grand grand multiparous women8.6± 1.5, 8.9 ± 1.2 and 9.3 ± 0.9, 9.5 ± 1.1 (assessment and intervention groups, respectively) were higher as compared to other parities. Regarding to the neonatal outcome the results revealed that there were slightly higher rate of meconium stained amniotic fluid, in the assessment group as compared to the intervention group with no statistically significant differences between the two groups. The study concluded that tbe grand grand multiparity carries the risk of maternal hypertension and diabetes mellitus,. which often leads to, induced labor or operative deliveries and placental disorders.