title: [Quadruplet pregnancies: management and obstetric and pediatric outcome].
abstract: Multi-fetal gestations are associated with increased frequency of maternal, fetal and neonatal complications. Data on the prognosis of multi-fetal pregnancies are of particular importance when the option of selective termination is considered. The present study details the obstetric management, neonatal outcome, and follow-up of seven quadruplet pregnancies in a french university center. The perinatal mortality was 250/1000. The neonatal mortality was 214/1000. The incidence of respiratory distress syndrome was 38%, bronchopulmonary dysplasia 19% and intraventricular hemorrhage 9.5%. Follow-up from one to 16 years shows that no child is handicapped. Our specific management for higher order multi-fetal pregnancies include early diagnosis, meticulous follow-up, early decrease of maternal activity, midwives at home, psychological care, delivery by cesarean section and a neonatalogist for each baby at the time of delivery.
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital Antoine-Béclère, Clamart.
authors.forename: J C
authors.initials: JC
authors.lastname: Pons
authors.forename: R
authors.initials: R
authors.lastname: Frydman
mesh_terms: D000032:Abortion, Therapeutic; D000328:Adult; D002585:Cesarean Section / Q000592:standards; D002985:Clinical Protocols / Q000592:standards; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000209:etiology; D009774:Obstetrics / Q000379:methods / Q000592:standards*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011272:Pregnancy, Multiple; D011379:Prognosis; D011783:Quadruplets