The Challenges Of Managing Quintuplets In A Developing Country (Nigeria)

Abstract

High order multiple deliveries have been reported from a number of developed countries previously but not from a developing country. This report highlights the challenges posed by the management of the second surviving quintuplet delivery in Nigeria at the University of Benin Teaching Hospital Benin, and the subsequent management of the babies. The first was at UNTH in 1988 but the mother took fertility drugs.

The challenges encountered during the antenatal care of the mother included the long stay in the hospital of the mother for bed rest, accurate diagnosis of the number of the babies prenatally, management of the weight of the mother and acceleration of the maturation of the babies' lungs. During delivery, resuscitation of the babies with the available health professionals, materials and equipment also posed some problems. Continuous ambubagging with oxygen was performed when some of them went apnoeic. Continuous positive airway pressure (CPAP) ventilation with a respirator (i.e. Mechanical ventilation), which was not available during resuscitation or early in their lives, could not be offered. Management consisted of using hot water bottles; perplex glass shied to maintain body temperature instead of incubators and respirators; which also were not available. It is recommended that adequate manpower, equipment and diagnostic procedures be made readily available to cope with such circumstances. This case is highlighted because this is the first known surviving quintuplet delivery in Nigeria by a mother without having taken fertility drugs and to evaluate the management of these babies and their mother in difficult circumstances.

Nigerian Journal of Clinical Practice Vol.6(1) 2003: 71-73