Title: Quadruplet Pregnancy Following Spontaneous Conception: A Rare Case Report

Authors: Veena Meena, Khuteta Sushila, Amarawatin Kurre, Kalpana Bariha, Meena Shyam

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i4.54

Abstract

Higher order (triplet or more) multiple pregnancies occur when more than two fetuses are present in the uterus at the same time. Quadruplets are a set of four offspring born at one birth which can be fraternal (multizygotic), identical (monozygotic) or a combination of both. Multizygotic quadruplets occur from fertilisation of four different sets of ovum and sperm. Monozygotic multiples are the result of a fertilized egg that splits into two or more embryos. Multizygotic quadruplets can be all male, all female, or a combination of both while monozygotic quadruplets will always be of the same gender. Here we present a case of 26-year-old G2A1L0 with previous history of one spontaneous abortion at 8 wk of gestation. After evaluation, she was found to carry three live foetuses with an IUFD. She was managed conservatively till 35 wk of gestation with regular monitoring of coagulation parameters. Elective caesarean section was done at 35 wk; two male, one female live babies and one IUFD male baby were delivered. This case is unique due to the fact that our patient conceived a multizygotic quadruplet pregnancy spontaneously after an abortion. One fetus died in utero and the pregnancy continued successfully resulting in 3 live born healthy babies.  

Keywords: Multiple gestations, Quadriamniotic quadrichorionic placenta, intrauterine death

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