Partogram of a grand multipara: different descent slope compared with an ordinary parturient.

Partograms of 42 grand multipara women (mean 10 previous deliveries) were analyzed and compared with the partograms of nulli- or second-/thirdpara women. All these full-term pregnancies were normal and the vaginal deliveries were spontaneous and non-instrumental. The grand multiparas had the shortest duration of the latent phase and the second stage of the delivery, but the active slope of the cervical dilation was in all groups same, on the average 2.8 cm/hour. The station of the presenting part of the fetus remained in the grand multipara group significantly higher than in the other parturients for the whole first stage of labor. During this delayed descent the normal rotation of the fetal head from occiput transverse to occiput anterior position was delayed and fetuses were often delivered in a low transverse head position. The cephalopelvic disproportion need not be the most obvious reason for a slow descent in a grand multipara delivery, but slow descent can be caused by the physiological changes due to the great number of previous pregnancies.