Abstract
INTRODUCTION AND IMPORTANCE: Quintuplets conceived spontaneously are a rare occurrence. As compared with singleton pregnancies, quintuplets are associated with high rates of obstetric complications and significant prenatal morbidity and mortality. To our knowledge, here we reported the first case of spontaneous quintuplet pregnancy faced by a practicing clinician in an underdeveloped country (Somalia) with a Successful outcome. CASE PRESENTATION: A 32-year-old woman presented in her third trimester of gestation at 30 weeks feeling pain and uterine contractions. CLINICAL FINDINGS AND INVESTIGATIONS: Ultrasound examination showed multiple pregnancies with four alive intrauterine pregnancies, but quintuplets could not be ruled out. Fetal heart activities were present, and the amniotic fluid was normal in amount. INTERVENTIONS AND OUTCOME: Extensive preparations made included four sets of ventilators. We did an emergency cesarean section under spinal anesthesia: five alive infants, three boys and two girls delivered in cephalic and breech presentations. CONCLUSIONS: Quintuplet pregnancy is rare but poses relevant clinical problems to both the obstetrician and the neonatologist. RELEVANCE AND IMPACT: The takeaway lesson from this case would be that Pregnancy with multiples is considered a high-risk pregnancy; with more complications observed as the number of fetuses increases, their effective follow-up requires early diagnosis with regular monitoring. Through this case, we would like to highlight the urgent need to focus on the delivery of women's health care services in Somalia, along with the need to recognize the importance of receiving antenatal care in the community so that the burden of thousands of lives that are lost each year could be reduced. This case report has been reported according to the SCARE Criteria (Agha et al., 2020).