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Monochorionic quadramniotic quadruplets: sonographic workup

I E Timor-Tritsch1, A Fleischer, A Monteagudo

  • 1Columbia-Presbyterian Medical Center, Sloane Hospital for Women, Department of Obstetrics and Gynecology, New York, NY 10032, USA.

Fetal Diagnosis and Therapy
|February 25, 1998
PubMed
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Early scanning of higher-order multifetal pregnancies is crucial. A monochorionic quadruplet case highlights the importance of timely diagnosis for appropriate clinical management and improved neonatal outcomes.

Area of Science:

  • Maternal-Fetal Medicine
  • Perinatology
  • High-Risk Obstetrics

Background:

  • Early identification of chorionicity and amnionicity in multifetal pregnancies is critical for optimal outcomes.
  • Higher-order multifetal pregnancies present unique management challenges.
  • Timely diagnosis impacts clinical decision-making regarding interventions like multifetal pregnancy reduction.

Observation:

  • A rare case of monochorionic/quadramniotic pregnancy was diagnosed via transabdominal scanning at 16 weeks.
  • The patient presented for consideration of multifetal pregnancy reduction.
  • Vascular connections between placentae were suspected, leading to the decision against reduction.

Findings:

  • The monochorionic quadruplet pregnancy was successfully managed non-interventionally.

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  • The patient delivered four healthy female neonates at 31 weeks gestation.
  • All neonates survived with minimal respiratory support, indicating a positive outcome.

    • Implications:

    • Routine early-onset ultrasound screening (8-10 weeks) is recommended for all multifetal pregnancies, especially higher-order gestations.
    • Accurate determination of chorionicity and amnionicity influences management strategies and potential complications.
    • This case underscores the importance of individualized management in complex multifetal pregnancies.