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At least 19 recordsLinked to original sources
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↗
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↗
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↗
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↗
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↗