 |
Case Report
Quadruplet pregnancy with widespread Tenney-Parker changes: A case report
1 Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Permian Basin, Odessa, Texas, USA
2 Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, School of Medicine, Texas Tech University Health Sciences Center, Permian Basin, Odessa, Texas, USA
3 School of Medicine Research Laboratory, Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Permian Basin, Odessa, Texas, USA
Address correspondence to:
Gary Ventolini
MD, FACOG, FAAFP, Professor of Obstetrics and Gynecology, University Distinguished Professor, Texas Tech University Health Sciences Center at the Permian Basin, 800 W. 4th Street, Odessa, TX 79763,
USA
Message to Corresponding Author
Article ID: 100120Z08ST2022
Access full text article on other devices
Access PDF of article on other devices
How to cite this article
Thomas S, Enakpene C, Sanchez A, Ventolini G. Quadruplet pregnancy with widespread Tenney-Parker changes: A case report. J Case Rep Images Obstet Gynecol 2022;8(1):24–28.ABSTRACT
Introduction: The incidence of multiple pregnancies has increased tremendously over the last 3–4 decades due to the advent of assisted reproductive technology treatment. Generally, multifetal pregnancy is associated with increase in maternal and perinatal morbidity and mortality, which are directly proportional with increasing numbers of fetuses in higher order multiple pregnancies.
Case Report: We present a case of a 26-year-old G1P0104 female with a 3-year history of anovulatory infertility. After the third cycle of ovarian stimulation with clomiphene citrate, she became pregnant with quadruplets. She had no significant past medical or surgical history. The pregnancy was a tetrachorionic-tetraamniotic quadruplet and it was relatively uncomplicated during the first and second trimesters. However, the patient had prolonged antepartum admission from 25w6d due to symptomatic preterm uterine contractions. At 31w3d, the patient underwent primary cesarean section due to non-reassuring fetal heart tracing and biophysical profile of quadruplet A. Four viable neonates were delivered, three females and one male. All four quadruplets were admitted to the Neonatal Intensive Care Unit (NICU) with varying degrees of neonatal complications due to prematurity, but they were discharged home between 8 and 9 weeks of life. The placental pathology showed Tenney-Parker changes, but it did not adversely affect the outcome of these infants.
Conclusion: Higher-order multifetal pregnancies can pose serious management challenges because of increased preterm delivery. Hence, management should be in a tertiary medical center with a multi-disciplinary team that includes an Obstetrician, Perinatologist, and Neonatologist.
Keywords: Antenatal surveillance, Cesarean section, Placental pathology and syncytial knots, Preterm contractions, Quadruplet pregnancy
SUPPORTING INFORMATION
Author Contributions
Serin Thomas - Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Christopher Enakpene - Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Asley Sanchez - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Gary Ventolini - Substantial contributions to conception and design, Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Serin Thomas et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
