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.