DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20171982

Successful quadruplet surrogate pregnancy after turbulent medical disorders in first trimester

Tochukwu Christopher Okeke, Aikay A. Ubaka, Augustine O. Olibe, Kenechukwu Olisa Okeke, Godwin U. Odoh, Cyril C. Ezenyeaku, Lawrence C. Ikeako, Emmanuel O. Izuka, Chidinma I Onwuka

Abstract


Quadruplet surrogate pregnancy is a rare pregnancy but, has become common due to assisted reproductive technology (ART). Its management is a big challenge to obstetricians and co-clinicians worldwide. This was a pregnancy managed at the University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria in a 33 year old hypertensive surrogate mother with turbulent first trimester medical disorders that called for termination of the pregnancy by other co-managing clinicians. However, the pregnancy became stable in late 2nd trimester with emergency caesarean section at 33 weeks following preterm premature rupture of membranes (PPROM). Its management was a big challenge that necessitated multidisciplinary approach with successful outcome of four healthy live babies (three males and one female) and the controversial practice of surrogacy


Keywords


Assisted reproductive technology, Multidisciplinary management approach, Quadruplet pregnancy, Surrogacy

Full Text:

PDF

References


Oxford English Dictionary, 2nd edition: quads used for quadruplets.

Elsner CW, Tucker MJ, Sweitzer CL, Brockman WD, Morton PC, Wright G et al. Multiple pregnancy rate and embryo number transferred during in vitro fertilization. Am J Obstet Gynecol. 1997;177(2):350-5.

Beemsterboer SN, Homburg R, Gorter NA, Schats R, Hompes PG, Lambalk CB. The paradox of declining fertility but increasing twinning rates with advancing maternal age. Human Reprod. 2006;21(6):1531-2.

Begum H, Moniruddin ABM, Jahan S. Quadruplet pregnancy: A rare occurrence. The Orion Med J. 2008;30: 570-1.

Savona-Ventura C, Gatt M, Vella K, Grima S. Higher order multiple pregnancy outcomes in the Maltese Islands. 2000-2004. Malta Med J. 2008;20(1):19-23.

Imrie S, Jadva V. The long-term experiences of surrogates: relationships and contact with surrogacy families in genetic and gestational surrogacy arrangements. Reprod Bio Medi Online. 2014;29(4):424-35.

Reproductive Law. Lisa Feldstrin Law Office. Retrieved October 6, 2016.

Umeora OJ, Umeora MC, Emma-Echiegu NB, Chukwuneke FN. Surrogacy in Nigeria: Legal, ethical, socio-cultural, psychological and religious musings. Afr J Med Health Sci. 2014;13(2):105-9.

Anu, Kumar P, Inder D, Sharma N. Surrogacy and women’s right to health in India: Issues and perspective. Indian J Public Health. 2013;57(2):65-70.

Pector EA. Ethical issues of high-order multiple births. Newborn and Infant Nursing Reviews. 2005;5(2):69-76.

Savona-Ventura C, Vella A, Zammit K. Temporal trends in multiple pregnancy rates in the Maltese Islands. Int J. Risk Safety Med. 2006;18(3):173-9.

Wang J, Lane M, Norman RJ. Reducing multiples pregnancy from assisted reproduction treatment: educating patients and medical staff. Med Journal of Australia. 2006;184(4):180-1.

Fertility: assessment and treatment for people with fertility problems. NICE Clinical guideline CG 156-Issued: February 2013.

Gerris J, De Sutter P, De Neubourg D, Van Royen E, Vander Elst J, Mangelschots K et al. A real-life prospective health economic study of elective single embryo transfer versus two-embyro transfer in first IVF/ICSI cycles. Human Reprod. 2004;19(4):917-23.

Conde-Agudelo A, Belzian JM, Lindmark G. Maternal morbidity and mortality associated with multiple gestations. Obstet Gynaecol. 2000;95:899-904.

Martin JA, Hamilton BE, Sutton PD, Osterman MJK, Curtin SC, Mathews TJ. Births: final data for 2002. Centres for disease control and prevention. Natl Vital Stat Rep. 2002;52:1-114.

Australian Multiple Birth Association (AMBA). Available from: http://www.amba.or.au/(Australia).