Severity: Warning
Message: file_get_contents(https://...@pubfacts.com&api_key=b8daa3ad693db53b1410957c26c9a51b4908&a=1): Failed to open stream: HTTP request failed! HTTP/1.1 429 Too Many Requests
Filename: helpers/my_audit_helper.php
Line Number: 176
Backtrace:
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 176
Function: file_get_contents
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 250
Function: simplexml_load_file_from_url
File: /var/www/html/application/helpers/my_audit_helper.php
Line: 3122
Function: getPubMedXML
File: /var/www/html/application/controllers/Detail.php
Line: 575
Function: pubMedSearch_Global
File: /var/www/html/application/controllers/Detail.php
Line: 489
Function: pubMedGetRelatedKeyword
File: /var/www/html/index.php
Line: 316
Function: require_once
Background: Multifetal pregnancies are high-risk pregnancies. Coexistence of conjoint twins with multifetal pregnancies further increases the risk factor, which is already considerably high with multiple births. Assisted reproductive techniques lead to an increase in multifetal pregnancies, especially monozygotic pregnancies, which in turn lead to an increase in the rate of conjoined twins.
Case: A spontaneously achieved quadruplet pregnancy with coexisting conjoint twins has not been reported previously. We report one such case of spontaneously achieved quadruplet pregnancy with coexisting conjoined twins.
Conclusion: Early (preferably first trimester) recognition of multifetal pregnancy, chorionicity, amnionicity and fetal malformation help in proper pregnancy management and optimizing outcome.
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