Is it possible to have quadruplets

Your medical team will help you decide where and when your babies will be born. To plan the birth of triplets or more, your medical team will weigh the risks of premature birth against the risks to both you and your babies of continuing the pregnancy. Generally, the longer your babies can stay in your uterus, the better. A normal pregnancy lasts 40 weeks. The average length of a pregnancy for triplets is 32 weeks and for quadruplets 30 weeks.

A caesarean section is usually considered safest when there are 3 or more babies. Giving birth to triplets or more vaginally is very rare and not recommended because of the higher risk of labour complications and infant mortality. Since almost all triplets or more will be born prematurely , they will need special care - for example, in a neonatal intensive care unit. It is important that the birth is planned in a hospital that has all the facilities that both you and the babies will need. In about 3 out of 4 cases, women who are pregnant with triplets will go into labour naturally before 35 weeks.

The signs and symptoms are the same as with normal labour, including:. Contact your medical team immediately if you have any signs of preterm labour. It may be possible to slow down or stop the labour. A caesarean section is usually the safest option when you are carrying 3 or more babies. This is because of the position of the babies, the position of the placenta or placentas , the risk that a placenta or umbilical cord can be compressed during a vaginal birth, and the risk that the babies can become entangled during a vaginal birth.

If you are carrying triplets or more, you will usually be offered a planned caesarean. You will be given a course of corticosteroids first. But for parents of quadruplets, their initial responses can be far from what can be called exuberance, at least in the early stages.

The practicalities of raising four babies to adulthood can seem utterly overwhelming, which is why experienced parents of higher order multiples HOM say it can help to just take things slowly at first and to allow the news to settle in, one steady day at a time.

The most common form of multiples are twins. The most common variety of quadruplets is formed when four separate eggs are fertilised by four separate sperm. There are however, a range of possibilities when it comes to the different combinations of quadruplets and how they are conceived.

Quadruplets may be identical, non identical or a combination of both. But tests revealed that one of the babies was not getting enough nutrients and was at risk of dying. A decision was made to deliver all of the babies that day, August 18 — three months earlier than her November 15 due date. A multidisciplinary team of specialists, including doctors to care for Ivanna and neonatologists to care for the newborns, staffed the operating room at Jackson Memorial Hospital for the emergency C-section.

In less than two minutes, Dr. Yasin delivered three boys and one girl — Julian, Sebastian, Gabriel, and Francesca. Multiple pregnancy is more common in women who utilize fertility medications to undergo ovulation induction or superovulation. Use of drugs to cause superovulation has caused the vast majority of the increase in the multiples. Assisted reproductive technology ART procedures such as in vitro fertilization IVF also contribute to the increase in the multiple birth rate. The risk of multiple pregnancy increases as the number of embryos transferred increases.

The duration of a normal singleton pregnancy ranges from 37 weeks to 42 weeks from the time of the last menstrual period. Twin pregnancies occasionally progress to 40 weeks but almost always deliver early. As the number of fetuses increases, the expected duration of the pregnancy decreases. The average duration is 35 weeks for twins, 33 weeks for triplets, and 30 weeks for quadruplets. Complications increase with each additional fetus in a multiple pregnancy and include many medical issues that will be discussed below.

In addition to these, there is a higher incidence of severe nausea and vomiting, cesarean section, or forceps delivery. If you are pregnant with twins or more, or if you are at risk for a multiple pregnancy, you should be aware of these and other potential problems you might experience. Preterm labor and birth pose the greatest risk to a multiple pregnancy. Cesarean section is often needed for twin pregnancies and is expected for delivery of triplets.

Since preterm labor and birth present such serious risks, the pregnant mother must understand the warning signs of early labor.

Sometimes, preterm delivery can be delayed by a few days or more if it is detected early. Each day gained provides valuable fetal growth and development. Once a woman is in advanced labor, delivery cannot be stopped. In rare instances, delivery of a second twin can be delayed. This delay, when possible, allows for continued growth in the protective environment of the uterus. Currently, there are no effective treatments to prevent preterm birth of multiples. The placenta is attached to the wall of the uterus, and the fetus is attached to the placenta by the umbilical cord.

The placenta provides blood, oxygen, and nutrition to the fetus through the umbilical cord. Placental function is more likely to be abnormal in a multiple pregnancy. If the placenta is unable to provide adequate oxygen or nutrients to the fetus, the fetus cannot grow properly. The placenta ages prematurely and may slow fetal growth, especially late in the third trimester. Another placental problem is twin-twin transfusion, a life-threatening condition in identical twins.

This transfusion occurs when blood flows from one fetus to the other through a connection in a shared placenta. Therapeutic amniocentesis and laser coagulation of blood vessels that link circulation to the twins in the placenta s may reduce complications of twin-twin transfusion.

Preeclampsia, also known as toxemia, occurs 2 to 5 times more often in multiple pregnancies. The condition may progress and threaten the health of the mother and baby. When severe, the mother may have seizures, and stroke or other life-threatening complications are possible.

Women with multiple pregnancies are more likely to develop gestational diabetes during pregnancy. Babies of diabetic mothers are more likely to experience respiratory distress and other newborn complications.

However, gestational diabetes is common even in singleton pregnancies, and treatment is well established and effective. Preterm delivery places an infant at increased risk for severe complications or early death.

Prematurity also may result in visual impairment or blindness. Neonatal intensive care unit admission is required for one-fourth of twin and three-fourths of triplet deliveries.

Despite these numbers, it is important to note that the vast majority of multiple-birth infants do survive. Fetal death occurs in about 1. Furthermore, compared to singleton pregnancies of the same birth weight, there is no significant increase in the incidence of chronic lung disease or brain, eye, or gastrointestinal problems in multiple-birth infants. Low birth weight of less than 5. The average birth weight is approximately 4 lb. As a result of prematurity, the risk for cerebral palsy is 4 times more likely to occur in twins.

The rates are even greater for triplets and high-order multiple births. Birth weight also corresponds closely to the severity of disability throughout the childhood years. As noted above, the average birth weight even for quadruplets is well above this number. Prevention during infertility treatment is the best approach to avoiding a multiple pregnancy. In ART cycles, limiting the number of embryos transferred is an effective approach.

Consult the ASRM Practice Committee Report titled Guidelines on Number of Embryos Transferred for recommendations regarding the optimal number of embryos to transfer based on patient age, embryo quality, and other criteria.

In the United States, physicians and patients jointly decide how many embryos to transfer. However, in England, no more than two embryos may be transferred in most cases. In Canada, a maximum of three embryos are recommended for transfer. The ultimate goal of ART is to achieve a high pregnancy rate while transferring a single embryo.

While physicians can transfer two embryos and still maintain acceptable pregnancy rates, the transfer of one embryo is associated with good pregnancy rates in certain patient groups, thereby resolving the problem of multiple pregnancies caused by multiple embryo transfer.

Multiple pregnancies are a known complication of ovulation stimulation drugs. Most physicians monitor patients with ultrasound examinations and blood tests.