A 30-year-old woman, identified as Kajal Vikas Khakardiya, gave birth to quadruplets at Krantisingh Nana Patil District Hospital in Satara, Maharashtra, in what doctors have described as an extremely rare event. The mother, a daily wage laborer from Saswad in Pune was in her third pregnancy. According to doctors, Kajal had earlier delivered triplets, making this case a “double rarity” as she went on to give birth to quadruplets in her third pregnancy.

Civil Surgeon Dr. Yuvraj Karpe, who supervised the delivery, said the successful outcome was a milestone for the government-run hospital. “Not only did our team ensure the survival of the mother, but all four newborns are currently stable under monitoring in the neonatal intensive care unit,” Dr. Karpe said. He also added that such a case was a first in Satara Civil Hospital.

Kajal was admitted to the hospital at 34 weeks of pregnancy after initially seeking care at the sub-district hospital in Koregaon. She was visiting her relatives in Koregaon and started having labor pains. Only after assessment by the doctors there, it was revealed to be a multiple gestation. The family was unaware of this situation. The case was transferred to Satara due to the complexity of the delivery. The four babies were delivered preterm and are under observation, which is standard in multiple pregnancies where complications such as low birth weight, respiratory issues, or feeding difficulties are common. The newborns were delivered via cesarean section and weighed between 1.3 kg and 1.8 kg each. Doctors confirmed they were kept in incubators under constant monitoring.

The babies were three girls and one boy. Hospital staff said their progress is being closely tracked, and pediatric specialists are ensuring they receive proper nutritional and medical care.

How Rare Are Quadruplet Births?

Naturally conceived quadruplet births are extremely rare, with global estimates suggesting odds as low as 1 in 700,000 pregnancies.¹ In India, such cases are seldom reported, with most multiple births occurring through assisted reproductive techniques such as in-vitro fertilization (IVF).

Medical literature highlights that the incidence of quadruplets, whether spontaneous or through fertility treatments, has increased in recent decades. However, spontaneous conception without fertility assistance remains rare.²

Causes and Risk Factors

Quadruplet pregnancies can occur due to several biological factors:

1. Hyperovulation – the release of more than one egg during ovulation, which may be influenced by maternal age, genetics, or hormonal variations.³

2. Familial predisposition – a family history of multiple births, particularly on the maternal side, may increase the likelihood of multiple ovulations.⁴

3. Nutritional and ethnic factors – some studies suggest higher rates of natural multiple pregnancies among certain populations, potentially linked to diet or genetic makeup.⁵

In Kajal’s case, no fertility treatments were used, making her delivery particularly noteworthy in the context of natural conception.

Health Risks in Quadruplet Pregnancies

While the outcome in Satara was successful, quadruplet pregnancies carry high risks for both mother and babies. These include:

• Preterm birth – More than 90% of quadruplet pregnancies deliver before 37 weeks, often leading to neonatal complications such as respiratory distress and underdeveloped organs.²

• Low birth weight – Each infant is typically born weighing less than 2.5 kg, increasing vulnerability to infections and long-term health issues.

• Maternal complications – Mothers face higher risks of preeclampsia, gestational diabetes, anemia, postpartum hemorrhage, and surgical delivery.⁶

Close monitoring, access to neonatal intensive care, and skilled obstetric intervention are essential in ensuring survival in such pregnancies.

Conclusion

Kajal’s case adds to the very limited number of naturally conceived quadruplet births reported in India. Doctors emphasized that her history of delivering triplets earlier makes this case particularly unique and noteworthy in medical records.

References

1. Rathod, S., S. K. Samal, S. Singh, and S. Swain. “Quadruplet Pregnancy Following Spontaneous Conception: A Rare Case Report.” Journal of Clinical and Diagnostic Research 9, no. 4 (April 2015): QD01–QD02. https://doi.org/10.7860/JCDR/2015/11899.5760.

2. Chittawar, P. K., et al. “Multiple Pregnancy: Boon or Bane—An Indian Perspective.” Journal of Human Reproductive Sciences (2022). https://www.researchgate.net/publication/365972356_Multiple_Pregnancy_Boon_or_Bane-An_Indian_Perspective

3. Stanford Children’s Health. “Overview of Multiple Pregnancy.”

   https://www.stanfordchildrens.org/en/topic/default?id=overview-of-multiple-pregnancy-85-P08019

4. Blickstein, I., & Keith, L. G. “Multiple Pregnancy.” New England Journal of Medicine (2005).

5. Derom, C., et al. “The Epidemiology of Multiple Births.” Human Reproduction Update (2001).

6. Hoque, M., et al. “Multiple pregnancy and maternal outcomes: a hospital-based study.” Annals of Medical and Health Sciences Research (2016). https://pmc.ncbi.nlm.nih.gov/articles/PMC5058718/

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