akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2020.211akusherstvo-1076Research ArticleОRIGINAL ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИPerinatal outcomes of quadruplet pregnancyПеринатальные исходы при четырехплодной беременностиhttps://orcid.org/0000-0003-2658-5417КалашниковС. А.KalashnikovS. A.

Калашников Сергей Аркадьевич – кандидат медицинских наук, доцент кафедры акушерства и гинекологии педиатрического факультета.

117997 Москва, ул. Островитянова, д. 1.

Sergey A. Kalashnikov - MD, PhD, Associate Professor, Department of Obstetrics and Gynecology, Faculty of Pediatrics, Pirogov Russian National Research Medical University.

1 Ostrovityanova Str., Moscow 117997.

homeksa@mail.ruhttps://orcid.org/0000-0002-3756-8332КудратоваД. Р.KudratovaD. R.

Кудратова Дилноза Равшановна - ординатор кафедры акушерства и гинекологии педиатрического факультета.

117997 Москва, ул. Островитянова, д. 1.

Dilnoza R. Kudratova - Resident, Department of Obstetrics and Gynecology, Faculty of Pediatrics, Pirogov Russian National Research Medical University.

1 Ostrovityanova Str., Moscow 117997.

Российский национальный исследовательский медицинский университет имени Н.И. Пирогова Министерства здравоохранения Российской ФедерацииРоссияPirogov Russian National Research Medical University, Health Ministry of Russian FederationRussian Federation202109092021154371378Copyright © Kalashnikov S.A., Kudratova D.R., 20212021Калашников С.А., Кудратова Д.Р.Kalashnikov S.A., Kudratova D.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/1076Introduction

Introduction. A significantly increased frequency of multiple pregnancies including more than two fetuses is a consequence of using assisted reproductive technologies and ovulation stimulations. However, such pregnancies remain poorly investigated. Aim: to study the course and perinatal outcomes of quadruplet pregnancies.

Materials and Methods

Materials and Methods. 7 pregnant women with quadruplets were examined. A comprehensive examination, including fetometry, monitoring of the cervical length, Doppler examination, and treatment of all complications were performed for all pregnant women. Results. Quadruplet pregnancy belongs to the peak risk group for the frequency of multiple gestational complications: cervical incompetence (85.7 %), anemia (71.4 %), preeclampsia (57.1 %), fetal growth retardation (71.4 %), premature birth (100.0 %), massive bleeding during delivery (33.3 %), extremely low birth weight newborns (30.8 %), respiratory disorders (100.0 %), intraventricular hemorrhages (38.5 %).

Conclusion

Conclusion. Women with quadruplet pregnancies should be monitored and give a birth in level 3 perinatal centers. Delivery should be preferentially performed by caesarean section. The data obtained additionally underline that as few as a single embryo should solely transferred.

Введение

Введение. Последствием применения методов вспомогательных репродуктивных технологий и стимуляторов овуляции является существенное повышение частоты развития многоплодия, в том числе с количеством плодов больше двух. При этом такие беременности все еще остаются малоизученными.

Цель исследования

Цель исследования: изучить течение и перинатальные исходы при четырехплодной беременности.

Материалы и методы

Материалы и методы. Были обследованы 7 беременных с четырехплодной беременностью. Всем выполнено комплексное обследование, включающее фетометрию, цервикометрию и доплерометрию, а также проведено лечение всех возникших осложнений.

Результаты

Результаты. Четырехплодная беременность входит в группу высочайшего риска по частоте возникновения многочисленных гестационных осложнений: истмико-цервикальной недостаточности (85,7 %), анемии (71,4 %), преэклампсии (57,1 %), задержки роста плода/плодов (71,4 %), преждевременных родов (100,0 %), массивной кровопотери в родах (33,3 %), а также по рождению детей с экстремально низкой массой тела (30,8 %), дыхательными расстройствами (100,0 %) и внутрижелудочковыми кровоизлияниями (38,5 %).

Заключение

Заключение. Беременные с четырехплодием должны наблюдаться и родоразрешаться в перинатальных центрах 3-го уровня. При выборе метода родоразрешения предпочтение следует отдавать операции кесарева сечения. Полученные данные еще раз подчеркивают необходимость ограничения числа переносимых эмбрионов до одного.

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The authors declare that there are no conflicts of interest present.