Abstract

Background: High order multiple gestations are an uncommon occurrence. The incidence of multiple gestation continues to decrease as the number of fetuses increase as calculated using Hellin’s rule: incidence = 1:80n-1 births, where n is the number of fetuses. Thus, the expected incidence of quadruplets is estimated at 1 in 512,000 births. All these have changed with the advent of reproductive technology. However, the occurrence of quadruplets as a natural process has remained rare globally. Objective: To report a case of a successful spontaneously conceived quadruplet with the death of one of the fetuses and delivery of 3 live fetuses and a twin papyraceous fetus at the 36th week of gestation. Methods: We report a case of a 28-year-old para-2 woman who had a spontaneous conception resulting in a quadruplet. She had an ultrasound diagnosis of death of one of the fetuses at 25 weeks of gestation. She was admitted twice in the course of the pregnancy and subsequently delivered at the 35th week of gestation. Results: A successful caesarean delivery of 2 fem ales and 1 male with a male papyraceous fetus.

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