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Another quad pregnancy

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  1. #1
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    Another quad pregnancy

    DH and I are having a really hard time making this decision.

    I'm 5'4'' and was about 123 lbs before getting pregnant. I have a 2 1/2 year old son conceived naturally and born healthy at term. I excercised a lot and had very low body fat- hence the infertility treatment. Luckily I've already put on about 10 lbs by 8 weeks.

    I'm pregnant with quads and my RE wants me to reduce to twins. DH and i agreed that we will only be willing to look at reducing to triplets. I have read that the m/c risks are very high for all of the babies when going from 4 to 3. It seems to me like the benefits of the reduction are not outweighing the potential consequences. What are the chances of spontaneous reduction when heartbeats are detected. I had an ultrasound at 7w1d (LMP):

    Baby A measured 6w4d HR 130 bpm
    Baby B measured 6w5d HR 125 bpm
    Baby C measured 6w6d HR 130 bpm
    Baby D measured 7w0d HR 125 bpm

    I am very scared and any insight/advice is appreciated.

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  3. #2
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    Congratulations on your pregnancy -- I am sorry that it is coming with this quandary.

    Almost 4 years ago I was pregnant with seven, ended up reducing to 2, had complications and ended up with my healthy daughter. She's now a little over 3 and seems to be none the worse for wear. I don't know if I'd say the same for me! It was a truly horrific pregnancy to live through.

    As to your question about the chances of losing one spontaneously, I don't really have an answer. Of the women who post here, it seems to happen rarely. I suppose that the miscarriage rate between 7wks w/ a heart beat and 10wks when you would reduce is pretty small, though you could multiply this by 4. I'd say, however, that we have all hoped that this would happen to take the responsibility away from us.

    I can't speak to the risks to the pregnancy from a 4 to 3 reduction -- I doubt there is much data on this. I do know that most MD's will recommend that you go down to 2 to give the remaining 2 the best chance of survival and intact health.

    I recommend that you talk with a specialist in multifetal reductions before making your decisions. This is a highly specialized procedure -- most women on this board had to travel to get it done. I'd expect that the specialist could talk with you by phone prior to the day to help you weigh the risks and benefits of reduction.

    Unfortanely, no one can make these decisions for you. We tried to make decisions that we thought we could live with. For us, we felt that we were at fault for producing the pregnancy (even though the chances of it happening were excedingly rare - we had 7 follicles prior to IUI). We felt that having our children live their lives with disabilities because of our mistake was worse than reducing. I suspect that not everyone would agree with us, but that was how we felt.

    Also -- make sure that you and your husband continue to talk openly about this. My husband and I were fortunately in agreement with each decision, but we processed the losses at different times and in different ways. My husband met with our priest and grieved around the time of the reductions. I was completely emotionally shut down at that time for self-preservation. By the end of the pregnancy, I was ready to mourn the losses - but by that time, my husband just wanted to put it all behind him and not dredge up the pain. This led to some hurt feelings and arguements as we each tried to pull the other person into our own grief schedule. We finally realized that we needed to support each other, but also not insist that the other person follow our plan.

    Last point -- I kept myself as emotionally distant from my pregnancy as possible until after the 1st reduction. I referred to "the aliens in my stomach" and didn't let myself think of them as anything more. I didn't watch the ultrasounds or listen to the heartbeats. For me, this just felt safer.

    I hope that this helps a little. Please post more questions, if you have them.

    38, DH 42

    DD: Meredith born May 7th, 2004. 32 weeks gestation.
    DS: Miles born April 23rd, 2008. Pulmonary lymphangectasia.

  4. #3
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    I agree with the advice of seeking sound medical advice before making any decisions. We recently reduced from 3-2. From my understanding, there is a pretty dramatic drop in risk factors when you move from carrying triplets to twins. We felt we had a responsibility to protect two healthy babies over putting all three at risk---but for every couple and individual, this choice is different. I think the average gestational rate for quads is 28 weeks, triplets 32 weeks and twins 36 weeks.

    I have a four-year-old and am now nearly 30 weeks pregnant with my b/g twins. Because I reduced, I believe I have been able to have a happy and healthy pregnancy-with no bedrest to date--while continuing to be a good mom to my daughter and wife to my husband. The babies are thriving and actually measuring ahead of their ages. I don't know what the scenario would have been if I had kept all three, but I am so thrilled with where I am now that this is what we choose to focus on. BTW, I am 5'4" and normally weigh around 125. Even at 30 weeks, just to warn you, I am now larger than when I delivered my dd. This last stretch will be tougher, and I don't feel there is any room left in me AT ALL. (I've already gained 29 lbs., which is right where my dr. wants me, but I feel HUGE.) Carrying multiples is much different than a single baby--even though I've had a fairly easy go of it compared to others.

    Good luck to you, and congrats on your pregnancy. I know you'll make the right decision for you and your family.

  5. #4
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    SR and Triplet Loss mentioned...

    Congratulations on your pg. I am SO sorry it's coming with such a difficult complication. The decision to reduce is not an easy one and it's not right for everyone, only you and DH, with the advisement of a medical team you trust, can make the decision that is right for your family.

    I have been pg 3 times~the first time I concieved fraternal triplets from a 3 embryo transfer of IVF and all 3 embryos took. I was confused and scared and didn't know what to do. My RE was honest with me about the possibile issues we faced with a triplet pg and my perinatologist recommended reduction. In the end, DH and I decided not to reduce. Unfortunately, my triplets were born prematurely and all three of them died after their births. It was truely devastating.

    My next pg was a singleton and although there were a LOT of complications, it resulted in the healthy, full term birth of my son.

    My last pg was another triplet pg. We transferred 2 embryos and against the odds, had an identical twin split. I knew there was no way I could carry triplets again and my DH and I reduced the identical twins. My healthy, daughter was born 9 weeks ago at 37 weeks.

    Reduction isn't an easy process, but for me and my family, it was the right decision. I coudln't handle the thought of losing more children from prematurity, nor did I want to increase the risks of my children having disabilities from prematurity.

    I urge you to find a perinatlogist that you trust and ask as many questions as you can~reduction does carry some risks, but so does carrying a higher order multiple pg. The more skilled the doctor is at reducing, the less risk there is from the procedure itself, so make sure your doctor has A LOT of experience with reduction (if that's the route you decide to go).

    Please ask your doctor if your pg could benefit if you reduce from 4 to 3. As was already mentioned, it's more common for quad pg to be reduced to twins, as this gives the mother a better chance of carrying to a longer gestation. I encourage you to collect as much information as you can and make the decision that is right for you and DH.

    Again, I'm sorry you are faced with this very difficult decision and I wish you the best of luck.
    Mom to angels: Hannah, Ryan and Abby. 10/24-10/28/03.
    Earth Angels: Joey b 5/08/05 and Laura b 5/26/07
    A butterfly lights beside us like a sunbeam. And for a brief moment, Its glory and beauty belong to our world…But then it flies on again, And though we wish it could have stayed, We feel so lucky to have seen it.

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