Quadruplet pregnancy following spontaneous conception: a rare case report

Quadruplets are a set of four offspring born at one birth which can be fraternal (multizygotic), identical (monozygotic) or a combination of both. Multizygotic quadruplets occur from fertilisation of four different sets of ovum and sperm. Monozygotic multiples are the result of a fertilized egg that splits into two or more embryos. Multizygotic quadruplets can be all male, all female, or a combination of both while monozygotic quadruplets will always be of the same gender. Here we present a case of 32-year-old G4P3L0 with previous history of three term intrauterine foetal death (IUFD) at 27 wk of gestation. After evaluation, she was found to carry three live foetuses with an IUFD. She was managed conservatively till 35 wk of gestation with regular monitoring of coagulation parameters. Elective caesarean section was done at 35 wk and three live female babies and one male still born were delivered. This case is unique due to the fact that our patient conceived a multizygotic quadruplet pregnancy spontaneously following a bad obstetric history (3 previous term intrauterine fetal deaths). One fetus died in utero and the pregnancy continued successfully resulting in 3 live born healthy babies.