2025 Annual Report

1/700 , 000 Odds of quadruplets occurring in a multiple pregnancy 1/7 , 000 , 000 Odds of this specific type of quadruplets occuring in a multiple pregnancy 1/80 The chances of twins occurring in a multiple pregnancy

Multiple pregnancies are rare, with twins occurring in one in 80 and quadruplets occurring in one in 700,000. Becca had a trichorionic quadra-amniotic pregnancy, meaning there were four babies and four sacs but only three placentas. “The odds of this specific type of quads are around one in 7 million,” said Ayodeji Sanusi, M.D., Becca’s maternal-fetal medicine physician at UAB. “Three eggs were fertilized; but one split, making two of the babies identical and two fraternal. It also added on to the complex and high-risk nature of her pregnancy.” Carrying more babies means an increased risk of complications, including preterm birth. To minimize these risks, Becca alternated weekly scans at her local obstetrician and the UAB Women and Infants Center.

MINIMIZING RISK FOR BETTER CHANCES FOR SURVIVAL

Around 19 weeks, her cervix started to shorten, a potential sign of oncoming labor. When her cervix had shortened more by her next appointment, Becca was admitted to UAB Hospital for continual monitoring for the duration of the pregnancy.

“We didn’t want to take the chance that I would go into preterm labor, or a complication arise with the babies, and I be over two hours away,” Becca said. “It was hard to leave my other kids; but I knew how important it was for me to be at UAB, where they had the resources and expertise needed to care for us.” The original goal was to get the babies to at least 32 weeks’ gestation, to balance the risks of prematurity and those of continuing pregnancy. Once Becca’s cervix shortened, the goal became 28 weeks.

A few weeks later, Lavareis arrived at UAB for a routine visit with Becca when her water suddenly broke. She was only 23 weeks and three days along, but did not experience additional signs of labor. Her care team was hopeful that they could delay delivery a little longer and adjust to a new plan. That night, Becca developed a high fever and abdominal tenderness, and both her and the babies’ heart rates started racing. The signs pointed to an infection, most likely due to her water breaking. The more she waited, the higher the risk to her and the babies’ lives.

The highest risk of complications and mortality for extremely preterm babies occurs during their first week of life.”

COLM TRAVERS, M.D.

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CHILDREN’S OF ALABAMA | UAB MEDICINE