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At least 19 recordsLinked to original sources
PubMed2000

Maternal neonatal outcome in quadruplet and quintuplet versus triplet gestations.

OBJECTIVE: Examination and comparison of the natural histories of triplet versus quadruplet and quintuplet gestations. STUDY DESIGN: A retrospective study of sixty-four multifetal pregnancies (fifty-two sets of triplets, nine sets of quadruplets and three sets of quintuplets) cared for during past 12 years in our department. Quintuplets and quadruplets were compared with triplet pregnancies according to gestational age, birthweight, pregnancy complications and perinatal outcome. Student's t-test, Fisher exact test and chi2 test were used for statistical analysis, considering P value of <0.05 as statistically significant. RESULTS: Although mean gestational age at delivery between triplets and higher order gestations was not significantly different, birthweight of quadruplets and quintuplets was significantly lower. Pregnancy complications, including intrauterine growth retardation, were equally distributed between the groups. Early neonatal and perinatal mortality were significantly higher in quadruplets and quintuplets than in triplets. Surprisingly, survival of growth retarded fetuses was better than survival of their eutrophic counterparts. The spontaneous loss rate was 11.5% for entire triplet gestation and 16.7% for quadru- and quintuplet pregnancies. CONCLUSIONS: As the spontaneous loss rate of triplets and higher order pregnancies observed in our study is quite similar to pregnancy loss rate caused by multifetal pregnancy reduction, conservative management of multifetal pregnancies in specialised tertiary centers seems to be a prudent solution.

Birth Weight↗
PubMed2001

Outcomes of quintuplet pregnancies.

OBJECTIVE: To review the obstetric and perinatal complications associated with quintuplet pregnancies in the United States. STUDY DESIGN: The databases of two large support groups for higher order multiple gestations, the Triplet Connection and Mothers of Super Twins, were accessed for quintuplet pregnancies. Each record contained information regarding maternal demographics, obstetric complications and perinatal outcomes. The data were analyzed by the Student t test and chi 2 test as indicated, with a P value < .05 for significance. RESULTS: Complete data were obtained for 36 quintuplet pregnancies. Preterm labor complicated all pregnancies. Six pregnancies delivered prior to 24 weeks' gestation, with no surviving infants. In the remaining 30 pregnancies, the mean gestational age at delivery was 28.9 weeks (SD +/- 2.0). There were trends toward later gestational ages at delivery in pregnancies with prophylactic cerclage placement and among multiparous women; however, these trends were not statistically significant. The perinatal mortality rate for the entire sample was 253/1,000. When adjusted for pregnancies delivered beyond 24 weeks' gestation, the perinatal mortality rate was 83/1,000. Minor and major neonatal morbidity affected 20% (26/132) and 10% (13/132) of quintuplet neonates, respectively. CONCLUSION: Quintuplet pregnancies are associated with high rates of obstetric complications and significant perinatal morbidity and mortality.

Adult↗
PubMed1992

Triplet, quadruplet and quintuplet pregnancies. Management and outcome.

The management and outcome of 46 pregnancies, 37 triplets, 7 quadruplets and 2 quintuplets, were analysed. Management of pregnancies, initiated upon diagnosis of multiple pregnancy, included bed rest, beta-mimetic agents, dexamethasone late in the second trimester and selective cerclage. The mean gestational age at labor was 235 days in triplet pregnancies, 241 for quadruplets and 220 days for quintuplets. Fifty-four percent of the deliveries were by cesarean section and the remainder per vaginam. The mean weight of the neonates was 1809 g for the triplets, 1837 g for quadruplets and 1284 g for the quintuplets. The mean overall Apgar score was 8.13, total perinatal mortality 14.8% and 9.4% in cases more than 28 weeks. There was no statistically significant difference in the outcome for triplets born vaginally or by cesarean section. In recent years there has been a pronounced reduction in neonatal mortality, dropping from 17.3% during 1970-78 to 5.9% from 1979 to 1983 (p less than 0.05), probably due to the improved neonatal treatment.

Adult↗
PubMed1987

[Quintuplets in Lommatzsch--a historical contribution on multiple birth research].

Quintuplets were born in the little town of Lommatzsch near Meissen and Dresden, Saxony, on June 25, 1688. This birth of quintuplets, though not yet considered by medical literature, is historically authentic. Evidences of this exceptional event are notations in the birth and death registers of the town parish church in Lommatzsch, a letter reporting on the "unusual event" to the elector Johann Georg III (1600-1691) and the so-called five-children gravestone. On the basis of these Lommatzsch quintuplets, the author deals with interesting aspects of social life and medicine within the living conditions in a small town around the turn from the 17th to the 18th century.- Other historical multiplets are referred.

Germany↗
PubMed1989

Stillbirth rate and weight at birth of quintuplets in Japan.

Nation-wide data in Japan on births and prenatal deaths of 16 sets of quintuplets during 1974-1985 were analysed. Among the 16 sets, 3 sets were liveborn, 8 were stillborn, and 5 were mixed, with a stillbirth rate of 0.64 (51/80). Effects of sex, maternal age and birth order on the stillbirth rate were not considered because of the small sample size. Effects of gestational age and birthweight on stillbirth rate were also examined. The mean weight of the 40 quintuplet individuals was 1,048 g.

Adult↗
PubMed1998

Delayed interval delivery in a quintuplet pregnancy.

We present a case report of delayed delivery of a quintuplet pregnancy. The pregnancy resulted from intrauterine insemination following hormonal treatment. This case may represent the first report of quintuplets delivered using the technique of delayed interval delivery. Three separate spontaneous labours and one Caesarean section for two fetuses took place between the 24th and 32nd weeks of pregnancy. The delay between the first and the last delivery was 61 days. Only a boy, born fourth, survived.

Adult↗
PubMed1975

Quintuplet pregnancy.

A quintuplet gestation after ovulation induction with clomiphene and HCG is described. This is the first quintuplet birth reported in Israel. The pregnancy was associated with ovarian hyperstimulation syndrome, toxemia of pregnancy, and pruritus gravidarum. Diagnosis and management of these cases pose a special problem for the obstetrician and neonatologist. The problem of multiple pregnancies and their control in the treatment of infertility with ovulation-inducing drugs is discussed.

Adult↗
PubMed1988

Anaesthesia for caesarean section in a parturient with quintuplet gestation, pulmonary oedema and thrombocytopaenia.

The case of a 32-year-old parturient with a quintuplet pregnancy is described. The pregnancy had been complicated by premature labour which was treated with ritodrine tocolysis. Betamethasone was administered to hasten fetal lung maturation. The ritodrine therapy was complicated with fluid overload and pulmonary oedema requiring intravenous diuretic treatment. The patient presented urgently for Caesarean section, with fluid overload and worsening thrombocytopaenia. Life-threatening pulmonary oedema was manifest in the immediate preinduction period, following insertion of a pulmonary artery catheter and surgery was delayed to improve the mother's condition with intravenous diuretic therapy. Induction was carried out with the patient in the sitting position, with cricoid pressure maintained to protect the airway as the patient was lowered to a wedged, supine position. Intravenous nitroglycerin was used to control blood pressure. Low pressure mask-bag ventilation was utilized to maintain oxygen saturation and the patient was intubated and ventilated with positive end-expiratory pressure. Positive pressure ventilation was continued for 24 hours postoperatively. The perioperative course is reviewed and followed by a discussion of the anaesthetic considerations for multiple gestation pregnancies.

Adult↗
PubMed1988

Endocrine response to selective embryocide in a gonadotropin-induced quintuplet pregnancy.

With the increase of medical induction of ovulation, the incidence of grand multiple pregnancy is becoming more frequent. We report the endocrine response of a quintuplet pregnancy that was reduced at 9 weeks' gestation to a twin pregnancy by selective embryocide and compared with quadruplet, triplet, and twin pregnancies. The human chorionic gonadotropin titer declined fourfold, but there were no clinically significant changes in the progesterone or estradiol levels. We conclude that, despite the drop in human chorionic gonadotropin, the placenta had attained adequate secretory maturation to prevent any significant decline in progesterone and estradiol levels, which demonstrates the efficacy of this procedure at this gestational age.

Abortion, Induced↗
PubMed1988

Management of quintuplet pregnancy by selective embryocide.

Selective embryocide was performed as a two-stage procedure in a patient with a quintuplet pregnancy in the first trimester. No complications occurred, and the patient was delivered of healthy twins at term. This procedure may be offered to selected patients with pregnancies with greater than five embryos.

Abortion, Induced↗
PubMed1990

The outcome of triplet, quadruplet, and quintuplet pregnancies managed in a perinatal unit: obstetric, neonatal, and follow-up data.

Multifetal gestation is associated with increased frequency of maternal complications and higher perinatal morbidity and mortality. The need for contemporary data on the outcome of multifetal gestations is further underscored when selective reduction is considered. The present study details the obstetric management, neonatal outcome, and follow-up data of 24 triplet, five quadruplet, and one quintuplet pregnancies delivered in a perinatal center. The early neonatal mortality rate was 31.6, the late neonatal mortality rate was 21, and the perinatal mortality rate was 51.5. Survival to discharge was 93%. The incidence of respiratory distress syndrome was 43%, bronchopulmonary dysplasia 6%, retinopathy of prematurity 3%, intraventricular hemorrhage 4%, and cerebral palsy 2%. Follow-up from 1 to 10 years shows that only one child is moderately handicapped, whereas 99% have no significant medical problem. Early diagnosis by ultrasonography, meticulous antenatal care, early hospitalization, delivery by cesarean section, and on-site availability of a neonatologist for each baby at the time of delivery are the probable major determinants of improved outcome.

Child Development↗
PubMed1980

Quintuplet pregnancies.

Five quintuplet pregnancies, following induction of ovulation with clomiphene and HMG-HCG, are the subject of this communication. In 3 women, pregnancy was associated with ovarian overstimulation, and two patients required emergency surgery because of torsion of an ovarian cyst. Two women aborted in mid-trimester, while the other 3 delivered by cesarean section at 33-35 wk gestation. 15 babies were born, weighing 700-2200 g. 8 infants suffered from respiratory distress syndrome and 5 babies were born with correctable malformations. 13 newborns survived, and all are mentally and physically well-developed. Four of the 5 women conceived again. The management of the patients during multiple gestation and the outcome of pregnancy are discussed.

Clomiphene↗
PubMed1995

Clinical course and systemic correlates of retinopathy of prematurity in quintuplets.

PURPOSE/METHODS: We studied clinical correlates of retinopathy of prematurity in four surviving quintuplets with similar low birth weights and gestational age of 27 weeks. Prospective serial ophthalmoscopic examinations and retrospective chart analysis were used. RESULTS/CONCLUSIONS: Retinopathy of prematurity varied among the neonates from stage 2 with total regression to threshold progressing to retinal detachment. Severity of eye disease correlated with duration of mechanical ventilation and of parenteral nutrition, as well as frequency of hypoglycemia and of hypercapnia. Poor outcome correlated inversely with weight gain.

Adult↗
PubMed1992

Delayed interval delivery of two remaining fetuses in quintuplet pregnancy after embryo reduction: report and review of the literature.

A case report is presented with a prolonged interval between delivery of 25 days. A quintuplet pregnancy resulted from hormonal stimulation of ovulation. Two fetuses remained after an embryo reduction was performed at 11 weeks gestation. At 22.5 weeks gestation the first twin (310 g) was delivered after spontaneous rupture of membranes. Using tocolytic agents, the second twin (710 g) was born at 26 weeks of gestation. This case is discussed and a review of the literature is given.

Abortion, Induced↗
PubMed2001

Three blastocyst stage embryo transfer resulting in a quintuplet pregnancy.

High-order pregnancies are associated with high morbidity and mortality and the incidence is increased as a drastic complication of assisted reproductive technology. This case presents a high-order pregnancy achieved by transfer of three blastocyst stage embryos resulting in a quintuplet pregnancy including a monochorionic triplet. Following the selective termination of the monochorionic triplet, two healthy children were born. The mechanism of monochorionic development and its association with assisted reproductive technology are discussed.

Adult↗
PubMed2004

Quintuplet pregnancy following transfer of two blastocysts: Case report.

A 36-year-old single woman presented at the out-patient clinic in March 2000 requesting donor insemination. Between May 2000 and May 2001 she underwent six cycles of intrauterine insemination with donor sperm after clomiphene citrate stimulation without achieving a pregnancy. In January 2002, ICSI was performed; two embryos were transferred on day 3 and a dizygotic bichorionic pregnancy was achieved, which ended in a miscarriage at 21 weeks of gestation. After a second unsuccessful ICSI attempt in which a single embryo transfer was performed, she embarked upon her third attempt in March 2003 at 39 years of age. Two blastocysts were transferred after ICSI, resulting in a quintuplet gestation consisting of a monochorionic biamniotic pregnancy and a monochorionic triamniotic pregnancy. The current case report indicates that monozygotic pregnancies consisting of both twins and triplets are possible after treatment by assisted reproductive technologies. An association between extended culture, manipulation of the zona pellucida, ovarian stimulation and occurrence of monozygotic pregnancies has been suggested by retrospective studies. However, in order to identify more reliably predictive factors for the occurrence of monozygotic pregnancies, it is necessary to perform prospective trials.

Abortion, Spontaneous↗
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↗