Selective Termination in Quintuplet Pregnancy During First Trimester

Kanhai, H. H. H.; Rijssel, E. J. C. Van; Meerman, Robert J.; Gravenhorst, J. Bennebroek

doi:10.1016/s0140-6736(86)91596-5

Cited by 58 publications

(18 citation statements)

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“…Excluding two cases with iatrogenic factors contributing to the prematurity, the rate still would have been 25 % . Of 22 previously reported pregnancies delivered beyond viability, 11 (50%) were premature [Aberg et al, 1978;Beck et al, 1980;Petres and Redwine, 1981;Redwine and Hays, 1986;Rodeck et al, 1982;Rodeck, 1984;Antsaklis et al, 1984;Kanhai et al, 1986;Dumez and Oury, 1986;Kerenyi and Chitkara, 198 11. There are no known prior reports of successful selective terminations in documented monochorionic pregnancies. These fetuses, which may be discordant for severe anatomical abnormalities, commonly share placental vessels which could lead to the death or possible compromise of the normal fetus after termination of the abnormal fetus [Benirschke, 19611. Much of this concern stems from reports of documented brain damage in the survivor after the spontaneous in utero death of a co-twin [Benirschke, 1961;Reismann and Pothak, 1966;Moore et al, 1969;Koronyi and Kovacs, 1975;Melnick, 19771.…”

Section: Discussionmentioning

confidence: 99%

“…With second trimester terminations half the duration of the pregnancy has becn completed under the influence of a multiple gestation with the uterus subjected to greater amounts of circulating hormones and a more rapid increase in size than the uterus of a singleton pregnancy. Of 11 first trimester reported terminations that have delivered (Kanhai et al, 1986;Dumez and Oury, 19863 four that were reduced to singletons all went to term. The remaining seven cases were reduced to twins with two sets delivering at term and five delivering prematurely.…”

Section: Discussionmentioning

confidence: 99%

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Selective termination of multiple gestations

et al. 1988

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Twenty-two selective terminations in multiple gestations were performed by a number of different methods. In 17 dichorionic pregnancies there was a successful delivery in surviving singletons or twins. In five monochorionic pregnancies undergoing selective termination there was a successful delivery in only one and a pregnancy loss in the other four. Six of the 18 delivered pregnancies were complicated by premature labor and delivery. Among the several methods used for selective termination, intracardiac potassium chloride injection appears to be the procedure of choice in dichorionic pregnancies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Selective termination of multiple gestations

et al. 1988

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“…Labor ensued, and the healthy quintuplets were delivered by Cesarean section. Kanhai et al ( 1986 ) punctured the hearts of three quintuplets at 10 weeks' gestation (one was repeated at 11 weeks). The mother subsequently delivered full-term healthy twin girls.…”

Section: Triplets and Higher Multiple Birthsmentioning

confidence: 99%

Multiple Pregnancies

Benirschke¹,

Burton²,

Baergen³

2012

Pathology of the Human Placenta

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“…Multifetal reduction is advised in higher-order multiples presumed to be multichorionic [36][37][38][39] . A high rate of spontaneous reduction of nearly 50% of all fetuses as part of quintuplet pregnancies has been reported so that it is advised to delay iatrogenic fetal reduction until 12 weeks gestation [40] .…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of a Spontaneous Monochorionic Five-Amniotic Quintuplet Pregnancy

Arabin

2009

Fetal Diagn Ther

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Objectives: It is the aim of this study to report on the prenatal diagnosis and course of a spontaneous monochorionic (MC) 5-amniotic (5A) quintuplet pregnancy which is such a rare event that it has up to now never been described antenatally. Case Report: A spontaneous MC 5A quintuplet pregnancy was diagnosed at 12 weeks by 2D ultrasound. Video tapes (2D and 4D) were made showing that 2D ultrasound still better documented simultaneous visualization of all quintuplets including their activities compared with 4D ultrasound, which, however, adds the information of space location. Variances of crown-rump length, nuchal translucency and nasal bone were evaluated. After informed consent and a second opinion of 2 centers performing invasive laser coagulation or occlusion of the umbilical cord, the parents decided to interrupt pregnancy. Pathologic evaluation confirmed MC 5A quintuplet pregnancy. Conclusion: The case demonstrates that splitting of 1 zygote into 5 embryos might even occur spontaneously. In view of the poor outcome and limited success of fetal reduction, pregnancy termination was finally part of the counseling.

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Selective Termination in Quintuplet Pregnancy During First Trimester

Cited by 58 publications

References 0 publications

Selective termination of multiple gestations

Selective termination of multiple gestations

Multiple Pregnancies

Prenatal Diagnosis of a Spontaneous Monochorionic Five-Amniotic Quintuplet Pregnancy

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