Successful urgent cerclage in a quadruplet gestation.
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.
Haraway
S D
SD
Department of Obstetrics and Gynecology, University of Oklahoma College of Medicine, Oklahoma City 73190, USA.
Schipul
A H
AH
Thomas
J S
JS
Rayburn
W F
WF
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*