Successful quadruplet surrogate pregnancy after turbulent medical disorders in first trimester
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
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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).