title: Successful urgent cerclage in a quadruplet gestation.
abstract: Pregnancies complicated by quadruplets are rare but at high risk for premature cervical dilation, premature deliveries, and increased perinatal mortality. This report presents a case of a patient carrying quadruplets whose cervix became 4 cm dilated at 21 weeks even though there were no reported uterine contractions. Despite bed rest and combination tocolytic therapy, the cervix dilated to 6 cm and the membranes protruded. Described here are refinements of an Olatunbosun technique to successfully perform the cerclage. Labor occurred at 32 weeks, and a cesarean delivery was performed before the transvaginal removal of the cerclage. The four appropriately-grown fetuses adjusted well in the intensive care nursery.
authors.affiliation: Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City 73190, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Haraway
authors.forename: A H
authors.initials: AH
authors.lastname: Schipul
authors.forename: J S
authors.initials: JS
authors.lastname: Thomas
authors.forename: W F
authors.initials: WF
authors.lastname: Rayburn
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000601:surgery; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011783:Quadruplets; D002581:Uterine Cervical Incompetence / Q000601:surgery*