Successful Expectant Management of a Dichorionic Quadruplet Pregnancy to 38weeks 1day Gestation Without Complication

Abstract

This is to report a case of successful expectant management to 38 weeks gestation of a Dichorionic Quadruplet without complication. A 26years old G3P22 Alive student presented for booking at the antenatal clinic of Holy Rosary Specialist Hospital & Maternity, Onitsha on 10/3/2015 following 16 weeks of amenorrhea. She had normal-term singleton pregnancies and deliveries in 2010 and 2013. She later had a perceived one-year period of secondary infertility and got pregnant after a course of Clomiphene Citrate. A booking ultrasound done on 24/3/2015 revealed an 18-week Dichorionic Quadruplet with compatible foetal parameters. There was no family history of multifetal pregnancies. She had an elective caesarean section on 12/08/2015, at a gestational age of 38 wks and 1 day. Findings at delivery include 3boys 1girl with excellent Apgar scores, and a birth weight range of 2.6-2.2kg. She recovered well from surgery and was discharged home on the 5th postoperative day. She came to the postnatal clinic on 24/09/2015 and had counselling for family planning. In conclusion: Quadruplet pregnancies can be expectantly managed successfully to 38 wks gestation as reported. Interventions like “Cervical Circle” and pre-term delivery are not “sine qua non” to the management of Quadruplet pregnancies.