Successful Quadruplet Pregnancy Following Ovulation Induced with Human Menopausal Gonadotropin and Human Chorionic Gonadotropin

Abstract

Induction of ovulation in anovulatory patients with gonadotropins has significantly increased the incidence of multiple gestations. A quadruplet gestation that occurred after induction of ovulation with human menopausal gonadotropin (HMG) and human chorionic gonadotropin (HCG) is described. All infants have survived, and have developed normally. The management of multiple gestations creates special problems for the Obstetrician. Early diagnosis and correct management with complete bedrest and hospitalization of the patient are essential for a successful outcome. Control of the patient with urinary estriols, ultrasound and daily vital signs are most helpful. Organization of an alert perinatal staff composed of Obstetricians, Pediatricians, and Anesthesiologists contributes to fetal salvage. Problems during the anteparturn and intraparturn care are discussed.

Gestação Trigemelar Espontânea: Complicações Maternas e Resultados Perinatais

“…Diversas condutas já foram propostas com o intuito de prolongar as gestações triplas, geralmente com casuística pequena e sem grupo controle, o que dificulta a avaliação de sua real eficácia. Alguns preconizam o repouso domiciliar desde o diagnóstico 10 , outros a partir da 20 a2,11 , ou da 27 a semana 12,13 . Para Holcberg et al 9 o repouso hospitalar prolongaria a gravidez, melhoraria o fluxo uterino, aliviaria desconfortos maternos (lombalgia, dispnéia, edema) e permitiria a intervenção imediata em caso de TPP.…”