In the bustling corridors of Mbarara Regional Referral Hospital (MRRH), a remarkable story of hope and joy is unfolding. Two sets of quadruplets, a phenomenon that occurs in only 1 in 700,000 women, have been born, bringing immense happiness to their families and the medical team that made it possible.
Two Families’ Journeys
Macklin Namara, 27, and her husband Kenneth Batuura, residents of Kyeizooba Igara Bushenyi district, were overjoyed when they discovered they were having quadruplets. “I visited other facilities for more scans, and I got mixed reactions. When I told my husband, who wasn’t around at the time, he calmed me down and welcomed it happily,” Namara said, reminiscing about her husband’s reaction.
The couple had spent two years in marriage, and this was their first pregnancy detected at the eighth week. Being a high-order pregnancy, it was wise for the couple to seek the highly specialized services of MRRH, away from home peripheral facilities. As her pregnancy progressed, Namara was admitted to the High-Risk Unit of Mbarara Regional Referral Hospital (MRRH) for close monitoring and care. Counseling was paramount as a team of dedicated medics continuously monitored both the mother and unborn babies. “I was experiencing difficulty breathing, and the babies were pushing against my diaphragm,” she explains.
Dr. Leevan Tibaijuka, an Obstetrician, was part of the team that offered her the best possible care from the day of admission up to the final delivery. “The plan was to prolong her pregnancy to 34 to 36 weeks, but when labor started at 32 weeks, we decided to opt for an emergency cesarean section.” The quadruplets’ arrival was met with joy and excitement. “It was an incredible moment when I first held my babies in my arms,” Namara says, beaming with pride. Her husband, Batuura, echoes her sentiments. “We are grateful for this blessing, and we are equally indebted to the health workers’ commitment at Mbarara Regional Referral Hospital.”
Namara speaks with a joyful face as she looks at the four little ones, two boys and two girls weighing 1.4kgs to 1.6kgs respectively. Being preterm babies, they have to be admitted to MRRH’s Neonatal Intensive Care Unit (NICU) as the pediatric team continues to provide them with the best possible care.
“We assess each baby to determine if their needs are being met. When they are preterm, they may struggle with breastfeeding, requiring intravenous (IV) fluids, and the family should receive health education,” said Doreen Katushabe, the NICU In-charge.
Caring for the quadruplets has been challenging for the husband, who should be working. “I change diapers every two hours, feed them every two hours. This is a full-time job, which means I can’t expect to be at work for some time. I also need two maids,” Batuura said.
Namara’s natural conception is a testament to the power of nature. While reproductive assisted technologies like in vitro fertilization, genetic factors can increase the likelihood of quadruplet pregnancies, her case is a reminder that miracles can still happen naturally.
The couple’s challenge and joy are shared by Juliet Amumpaire, 37, who also delivered quadruplets from the same facility.
“I came here last Thursday when I was feeling a lot of discomfort. The following day, I had breathing complications, but I kept on receiving all the medical support from MRRH health workers.”
On April 22, she gave birth to monozygotic quadruplets, in this case four girls of the same gender at 36 weeks.
Dr. Caxton Kakama was among the team of doctors that delivered her through cesarean section, and it was her second pregnancy, having had identical twins in 2018.
Amumpaire’s offspring weighed 1.6kgs to 1.9kgs respectively and had to be taken to NICU to come to terms and only returned to the mother for breastfeeding.
A beaming face is realized as Amumpaire talks about her beautiful bouncing neonates, but the husband’s life is already entangled in the cage of worries.
Leonidas Arinaitwe, 37, a local photographer and farmer, is perturbed about how to meet his financial obligations to support the family with his daily monthly income of 250,000 Uganda shillings.
“I am also a farmer who grows coffees and matooke on a small scale because of limited land. My income is very small compared to my already existing family, but with four more I am headed for a bigger struggle”, he says.
Another issue intriguing the man how is whether the newly born mother will be able to satisfy breastmilk needs for all four little ones.
Breastfeeding and hygiene
Experts reassure Quadruplet mothers to exclusively breastfeed their babies for six months to support their growth and development. While it’s natural for mothers to worry about meeting the demand, the body is capable of producing enough breastmilk as needed.
Dr Stella Kyoyagala, MRRH Pediatrician expounds that a well-balanced diet and plenty of fluids can help facilitate production. She adds, “Additionally, good hygiene practices are crucial to prevent infections and ensure a healthy environment for the babies.”
Medical Marvel
This rare and special occurrence happens when four separate eggs are fertilized by four separate sperm, resulting in four unique embryos, known as multizygotic quadruplets. Alternatively, in some cases, one fertilized egg can split into four identical embryos, called monozygotic quadruplets.
Other theories contend that quadruplets may result from a natural set of identical twins combined with another set of identical twins conceived through fertility treatments. Alternatively, a set of non-identical twins may be conceived naturally, and then a monozygotic pair forms, making a total of four embryos.
It’s worth noting that multizygotic quadruplets can be of the same gender or a combination of genders, whereas monozygotic quadruplets will always be of the same gender.
Findings suggest that while 90% of all multiple births consist of twins, 10% are shared between triplets and quadruplets, with the latter remaining a rare occurrence even with assisted contraceptives.
“Mothers carrying all these babies are likely to deliver before the required nine months of pregnancy. Their delivery has to be planned, and the further they push the pregnancy, the better the outcomes,” says Dr. Kakama.
In a world where miracles are rare, the birth of two sets of quadruplets is a reminder of the power of hope, joy, and medical expertise. As these families embark on their journey, they are surrounded by love, support, and the knowledge that their babies are a precious joy to the family.
About the Author
Halson Kagure serves as the Public Relations Officer for Mbarara Regional Referral Hospital, which also functions as a teaching center for Mbarara University of Science and Technology and other medical institutions.
