Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-24T05:28:07.607Z Has data issue: false hasContentIssue false
  • English
  • Français

Management and Outcomes of 65 Quadruplet Pregnancies: Sixteen Years' Experience in France

Published online by Cambridge University Press:  01 August 2014

J.C. Pons ,
L. Nekhlyudov ,
N. Dephot ,
S. Le Moal  and
E. Papiernik
J.C. Pons*
Affiliation:
Service de Gynécologie-Obstétrique, Maternité de Port-Royal, Paris, France
L. Nekhlyudov
Affiliation:
Mount Sinai School of Medicine, New York, NY
N. Dephot
Affiliation:
Service de Gynécologie-Obstétrique, Maternité de Port-Royal, Paris, France
S. Le Moal
Affiliation:
Service de Gynécologie-Obstétrique, Maternité de Port-Royal, Paris, France
E. Papiernik
Affiliation:
Service de Gynécologie-Obstétrique, Maternité de Port-Royal, Paris, France
*
Service de Gynécologie-Obstétrique, Maternité de Port-Royal, 75679 Paris Cedex 14, France

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Objective: data on the prognosis and management of multifetal pregnancies are of vital importance, particularly when the option of selective termination is considered. The present study details the obstetric management, neonatal outcome, and follow-up data of 65 quadruplet pregnancies in France.

Methods: to conduct the study, a questionnaire was sent to families registered with the National Association Helping Parents of Multiple Births (Association National d'Entraide des Parents de Naissance Multiples, A.N.E.P.N.M.).

Results: of 116 questionnaires sent to families of quadruplets born between 1972 and 1988, 65 were received. Of these pregnancies, 58 were obtained with ovulation induction agents, 2 with IVF (in vitro fertilization) and GIFT (gamete intrafallopian transfer) and 5 were spontaneous. Diagnosis was made prior to 13 weeks gestation in 87.2% of cases. Most mothers were hospitalized prior to delivery – mean duration of 47 days. The mean gestational age at delivery was 31.2 ± 3 weeks with a prematurity rate of 97%. Cesarean sections were performed in 51 cases and vaginal deliveries in 14. Neonatal and perinatal mortality rates were 68 and 104 per 1000, respectively. Birthweights of quadruplets ranged from 760 to 2455g with a mean of 1615 g.

Conclusion: management of quadruplet pregnancies in France consists of early diagnosis, echographical and clinical monitoring, early reduction of maternal activity and cesarean deliveries. Our management of such pregnancies is of high quality as reflected by our obstetrical results. Lack of adequate management, as perceived by families of quadruplets, exists at two levels: a psychological (lack of psychological support) and a financial (lack of specific help).

Keywords

Quadruplet pregnancyMultiple pregnancyMultifetal pregnancyOvulation inductionIn vitro Fertilization (IVF)
Type
Research Article
Information
Acta geneticae medicae et gemellologiae: twin research , Volume 45 , Issue 3 , July 1996 , pp. 367 - 375
Copyright
Copyright © The International Society for Twin Studies 1996

References

REFERENCES

1.Bieniarz, J, Shah, N, Dmoski, WP (1978): Premature labor treatment with ritodrine in multiple pregnancy with three or more fetuses. Acta Obstet Gynecol Scand 57: 25–30.Google Scholar
2.Botting, BJ, MacDonald Davies, I, Macfarlane, AJ (1987): Recent trends in the incidence of multiple births and associated mortality. Arch Dis Child 62: 941–950.Google Scholar
3.Collins, MS, Bleyl, JA (1990): Seventy-one quadruplet pregnancies: management and outcome. Am J Obstet Gynecol 162: 1384–1392.Google Scholar
4.Evans, MI, Fletcher, JC, Zador, IE, Newton, BW, Quigg, MH, Struyk, CD (1988): Selective first trimester termination in octuplet and quadruplet pregnancies: clinical and ethical issues. Obstet Gynecol 71: 289–296.Google ScholarPubMed
5.Gonen, R, Heyman, E, Asztalos, EV, Ohlsson, A, Pitson, LC, Shennan, AT, Milligan, JE (1990): The outcome of triplet, quadruplet, and quintuplet pregnancies managed in a perinatal unit: obstekic, neonatal, and follow-up data. Am J Obstet Gynecol 162: 454–459.Google Scholar
6.Imaizuni, Y, Inouye, E (1984): Multiple births rate in Japan, further analysis. Acta Genet Med Gemellol 33: 107–114.Google Scholar
7. La situation démographique en 1987. INSEE, n. 603 des Collections de l'INSEE, Série D, n. 131, 04 1989.Google Scholar
8.Loucoloulos, A, Jelewicz, R (1982): Management of multifetal pregnancies: sixteen years' experience at the Sloane Hospital for women. Am J Obstet Gynecol 143: 902–905.Google Scholar
9.MacFee, JG, LodEdward, L, Jeffrey, RL, O'Meara, O, Josepher, HJ, Butterfield, LJ, Thompson, HE (1974): Multiple gestations of high fetal number. Obstet Gynecol 44: 99–106.Google Scholar
10.Miettinen, G (1954): On triplet and quadruplet in Finland. Acta Paediatr 43 (suppl. 99): 23–81.CrossRefGoogle ScholarPubMed
11.Petrikovsky, BM, Vintzinleos, AM (1989): Management and outcome of multiple pregnancy of high fetal order: Literature review. Obstet Gynecol Survey 44: 578–584.CrossRefGoogle ScholarPubMed
12.Pons, JC, Frydman, R (1992): Les grossesses quadruples: prise en charge et evolution obstetrico-pédiatrique. J Gynecol Obstet Biol Reprod 21: 557–562.Google Scholar
13.Ron-El, R, Caspi, E., Schreyer, P (1981): Triplet and quadruplet pregnancies and management. Obstet Gynecol 57: 458–463.Google Scholar
14.Shennan, AT, Millican, JE, Yeung, PK (1979): Successful management of quadruplet pregnancy in a perinatal unit. Can Med Assoc J 121: 741–745.Google Scholar
15.Vervliet, J, DeCleyn, K, Renier, M, Janssen, P, Buyteart, Ph, Gerris, J, Delbeke, L (1989): Management and outcome of 21 triplet and quadruplet pregnancies. Eur J Obstet Gynecol Reprod Biol 33: 61–69.CrossRefGoogle ScholarPubMed
16.Wu, IH, Kenneweg, W, Langer, A (1983): Successful management of a quadruplet pregnancy. A case report. J Reprod Med 28: 163.Google ScholarPubMed