**Preterm Birth**

**Chapter 8**

**Provisional chapter**

**Quadruplets and Quintuplets**

**Quadruplets and Quintuplets**

Artemis Pontikaki, Dimitrios P. Koutsoulis, Christodoulos Akrivis, Dimitrios Akrivis and

Artemis Pontikaki, Dimitrios P. Koutsoulis, Christodoulos Akrivis, Dimitrios Akrivis and

Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.80338

established for most of the cases.

**Keywords:** quadruplet, quintuplet, high-order, management

Ioannis Kosmas

Ioannis Kosmas

**Abstract**

**1. Introduction**

Stelios Fiorentzis, Styliani Salta, Michail Pargianas,

Stelios Fiorentzis, Styliani Salta, Michail Pargianas,

DOI: 10.5772/intechopen.80338

A high-order pregnancy is always a challenge not only for the couple but also for the obstetrician, the pediatricians, the midwives, and the whole stuff of an obstetric clinic. The breakthroughs of infertility treatments have made more couples to postpone the birth of their children until they feel professionally and financially safe, many times after the age of 40. The advanced age of the mother puts extra pressure to the clinician for immediate success, leading to a rise of high-order pregnancies until the introduction of regulations and laws in many countries. The cost of a quadruplet and quintuplet pregnancy can be unbearable, not only financially but also psychologically. The management of such a pregnancy is also challenging since its beginning and to the end. Modern techniques and methods can also be difficult to be implemented on a quadruplet of quintuplet pregnancy because of the fear of losing four or five embryos at once. At the same time, the limited number of cases makes it almost impossible for studies to be made and guidelines to be

"High-order pregnancy" is defined by the presence of three or more fetuses. Before the introduction and widespread of modern fertility methods, a high-order pregnancy was rare and unique. The first recording of quadruplets, the Smiths, was in 1750 [1]. In 2009, Samson described again the Gehri quadruplets, born in 1880, the first to have survived to adulthood.

> © 2016 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

#### **Chapter 8 Provisional chapter**

#### **Quadruplets and Quintuplets Quadruplets and Quintuplets**

Stelios Fiorentzis, Styliani Salta, Michail Pargianas, Artemis Pontikaki, Dimitrios P. Koutsoulis, Christodoulos Akrivis, Dimitrios Akrivis and Ioannis Kosmas Stelios Fiorentzis, Styliani Salta, Michail Pargianas, Artemis Pontikaki, Dimitrios P. Koutsoulis, Christodoulos Akrivis, Dimitrios Akrivis and Ioannis Kosmas

Additional information is available at the end of the chapter Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.80338

#### **Abstract**

A high-order pregnancy is always a challenge not only for the couple but also for the obstetrician, the pediatricians, the midwives, and the whole stuff of an obstetric clinic. The breakthroughs of infertility treatments have made more couples to postpone the birth of their children until they feel professionally and financially safe, many times after the age of 40. The advanced age of the mother puts extra pressure to the clinician for immediate success, leading to a rise of high-order pregnancies until the introduction of regulations and laws in many countries. The cost of a quadruplet and quintuplet pregnancy can be unbearable, not only financially but also psychologically. The management of such a pregnancy is also challenging since its beginning and to the end. Modern techniques and methods can also be difficult to be implemented on a quadruplet of quintuplet pregnancy because of the fear of losing four or five embryos at once. At the same time, the limited number of cases makes it almost impossible for studies to be made and guidelines to be established for most of the cases.

DOI: 10.5772/intechopen.80338

**Keywords:** quadruplet, quintuplet, high-order, management
