Welcome to the ePoster Viewing Panel of AICOG 2025

Introduction-Spontaneous Heterotopic pregnancies with more than two fetuses in natural conception are very rare. Quadruplet pregnancy has an incidence of 1 in 512000 to 1 in 677, 000 births . Abdominal pregnancy is a rare, life-threatening condition in which an embryo primarily implanted in the fal-lopian tube, extruded, or expelled, and then secondarily implanted on another intra-abdominal surface with an incidence of 1 in 10,000 live births. So a Quadruplet pregnancy with one fetus in abdomen is a challenge for an obstetrician. Case for poster 24 year old woman G2P1L1 with 8 months pregnancy with previous 1 LSCS was referred from Panipat with quadruplet heterotopic pregnancy with suspicion of ruptured uterus. There was a history of delivery of 1st dead fetus at home. After informed consent, an emergency laparotomy was performed. 2 Dead fetuses were extracted. 3rd fetus was found wrapped in a sac within the omentum with both hands deformed & contractures present(secondary abdominal pregnancy). Uterus was ruptured, extending up to the cervix and vagina with friable borders, necessitating a hysterectomy. Postpartum period was uneventful. Conclusion- This is a rare case of quadruplets in spontaneous heterotopic pregnancy with advanced secondary abdominal pregnancy. High order pregnancy is considered a high risk due to an increase in maternal, fetal and neonatal morbidity and mortality. Antenatal care must be strengthened at the root level.