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PubMed1991

Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin.

A patient who suffered from polycystic ovarian disease and anovulation, was treated with pure follicle stimulating hormone for induction of ovulation. The treatment was stopped and human chorionic gonadotrophin was not administered because of high serum oestradiol levels and multiple follicular development. Ovulation occurred 11 days after pure follicle stimulating hormone was discontinued, the patient developed third-degree ovarian hyperstimulation syndrome and conceived with a quintuplet pregnancy.

Adult↗

PubMed1992

Quintuplets with clefts: follow-up at ten years of age.

A set of quintuplets, three of which were born with various degrees of oral clefting, were followed up to the age of 10 years. Study models, as well as panoramic and intraoral roentgenograms were collected at ages 5 and 10 years. Cephalometric roentgenograms were added at the age of 10 years. Analysis of the growth charts for height and weight indicated normal somatic development, save for a persistent, albeit diminishing, lag for the two most severely affected siblings. The latter also demonstrated a more vertical craniofacial growth pattern. The dental arch dimensions were within normal range, except for the maxillary and mandibular widths in the two more affected siblings, who also exhibited a delay of one or two stages of dental development in an intersibling comparison. These findings indicate that in the more severely affected siblings, there was only partial growth catch-up at the age of 10 years.

Cephalometry↗

PubMed1985

Quintuplets with clefts: follow-up at 5 years.

Follow-up observations are presented of a set of quintuplets at 5 years of age. Three of the children were born with different degrees of oral clefting. Height and weight comparisons between siblings with clefts and those without reveal that the most severely affected children lagged in their height measurements at the age of 5 years. This may indicate need for special awareness when caring for such children. A relative constriction of the anterior segment of the maxillary dental arch in two of the affected siblings may reflect a possible effect from previous surgical intervention.

Body Height↗

PubMed1980

Clefts in quintuplets--a case report.

A report of clefting in three siblings of quintuplets, following treatment with Pergonal, is presented. It is suggested that the varying degrees of the abnormality may be related to cramped intra-uterine conditons or differing pressures at a critical developmental stage. To our knowledge, no previous reports of congential abnormalities associated with Pergonal therapy exist, and we feel that the causal relationship should be explored using a suitable animal model.

Alveolar Process↗

PubMed1981

Quintuplet gestation. A case report.

The incidence of multiple gestation has increased as a result of ovulation stimulation in recent years. The early diagnosis by ultrasonography of the quintuplet gestation and the institution of special treatment to prevent the most common complications are discussed. The patient was delivered of five male infants at caesarean section after early rupture of membranes. Routine scanning during the first trimester plays an important role in the diagnosis of multiple gestation early in pregnancy. In the present case ultrasonography was used extensively in conjunction with other parameters. We feel that this management may have contributed largely to the successful outcome.

Adult↗

PubMed1993

[Anesthetic management for cesarean section in two parturients with quintuplet gestation].

Two parturients with quintuplet pregnancy underwent urgent or elective cesarean section under general anesthesia at 30 and 29 week gestational ages respectively. Since multiple gestation pregnancy requires enough medical staffs and instruments for preterm newborn resuscitation, emergency cesarean delivery was avoided. For cesarean delivery, the operation was started immediately after crash induction and intubation, and less than 1% isoflurane balanced with 60% nitrous oxide was used before birth in attempt to maintain uterine relaxation and sufficient utero-placental perfusion. After the delivery, aggressive maneuvers with PGE1 infusion, intravenous ergometrine and oxytocin, and interruption of volatile anesthetic inhalation (replaced by buprenorphine) were employed for decreasing the blood loss. The anesthesia and postoperative course of two patients and their babies were uneventful. Thus, anesthetic considerations may include; 1) high risk pregnancy related with huge pregnant uterus, 2) preterm labor, 3) preparation of sufficient man-power and instruments, 4) to avoid uterine contraction before delivery for fetal oxygenation, and 5) the puerperal promotion of uterine contraction to decrease blood loss.

Adult↗

PubMed1995

Clomiphene-induced quintuplets with a failed attempt at delayed-interval delivery.

Clomiphene citrate is widely used for ovulation induction. It is associated with a 6 to 17% incidence of multiple gestation. We report on a 27-year-old para 0010 patient who, after an initial evaluation for secondary infertility of 2 years' duration, was deemed to have oligo-ovulation. She conceived during the second cycle of clomiphene citrate administration. An early obstetric sonogram identified five fetuses with cardiac activity. The patient experienced preterm premature rupture of the membranes at 19 weeks gestation. A delayed-interval delivery was attempted, but all five fetuses were born over a period of 15 days. No maternal complications occurred. Multiple pregnancies of high order are commonly associated with human menopausal gonadotropins but rarely with clomiphene citrate. This is the seventh reported case of quintuplets related to clomiphene citrate, and possibly the first on whom no other fertility-enhancing medication was utilized. In this case, attempted delayed-interval delivery was not successful.

Adult↗

PubMed1991

First-trimester prenatal diagnosis in quintuplets: a practical approach using step-by-step embryo reduction.

A multiple pregnancy of high rank may occur in a couple at risk for a Mendelian disorder. Prenatal diagnosis is hampered by the difficulty of (1) obtaining chorionic villi from each zygote and (2) unequivocally relating each sample to the corresponding embryo. The calculation of the genetic risk according to the number of zygotes led us to propose a diagnostic strategy based on embryo reduction, a technique initially designed to improve the perinatal outcome of multiple pregnancies with normal embryos. We report a case in which this approach allowed rational use of first-trimester chorionic villus sampling in a quintuplet pregnancy at risk for non-ketotic hyperglycinaemia, resulting in the selective birth of unaffected twins.

Abortion, Therapeutic↗

PubMed2001

Monopaternal superfecundation of quintuplets after transfer of two embryos in an in vitro fertilization cycle.

OBJECTIVE: To present the first genetically proven identity of quintuplets in an IVF treatment cycle after transferring only two embryos. DESIGN: Case report. SETTING: IVF unit and obstetrics department of university-affiliated general hospital. PATIENT(S): Twenty-five-year-old patient undergoing IVF treatment for unexplained infertility. INTERVENTION(S): In vitro fertilization with intracytoplasmic sperm injection performed on 50% of oocytes, resulting in successful production of nine early-cleavage embryos. Transfer of two embryos on day 3 and freezing of the remaining embryos. MAIN OUTCOME MEASURE(S): Development of five separate embryonic sacs. Fetal reduction of three embryos at 12 weeks of gestation. RESULT(S): Successful completion of the twin pregnancy and full genetic analysis of the three embryos and the twins that were born at term. CONCLUSION(S): Despite transferring only two embryos, superfecundation occurred, resulting in five embryos. Genetic analysis can be used to determine paternity and identity of all the embryos.

Adult↗

PubMed2000

A Second Luminous Blue Variable in the Quintuplet Cluster.

H- and K-band moderate-resolution and 4 µm high-resolution spectra have been obtained for FMM 362, a bright star in the Quintuplet Cluster near the Galactic center. The spectral features in these bands closely match those of the Pistol Star, a luminous blue variable and one of the most luminous stars known. The new spectra and previously obtained photometry imply a very high luminosity for FMM 362, L>/=106 L middle dot in circle, and a temperature of 10,000-13,000 K. Based on its luminosity, temperature, photometric variability, and similarities to the Pistol Star, we conclude that FMM 362 is a luminous blue variable.

Journal Article↗

PubMed2006

Pinwheels in the Quintuplet cluster.

The five enigmatic cocoon stars, after which the Quintuplet cluster was christened, have puzzled astronomers since their discovery. Their extraordinary cool, featureless thermal spectra have been attributed to various stellar types from young to highly evolved, whereas their absolute luminosities place them among the supergiants. We present diffraction-limited images from the Keck 1 telescope that resolve this debate with the identification of rotating spiral plumes characteristic of colliding-wind binary "pinwheel" nebulae. Such elegant spiral structures, found around high-luminosity Wolf-Rayet stars, have recently been implicated in the behavior of supernovae light curves in the radio and optical.

Journal Article↗

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