Quadruple The Load But Worth It

Prior Infertile Mom Finds She's Carrying Four

For nearly four months, Cathy Cimoch was poked and tested, medicated and monitored. She wasn't sick; she was pregnant. And the 38-year-old was carrying not just one but four babies. Cimoch and her husband say their fertility doctor did not prepare them for this.

48 Hours Correspondent Sharyl Attkisson reports on her ordeal.



After struggling for years to conceive, Cimoch decided not to selectively reduce the number of embryos when she found out she was pregnant with four. She was ready to do almost anything to give all of her embryos a fighting chance at survival. So was Dr. John Elliott of Phoenix, Ariz.

Over the last 12 years, Dr. Elliott and his partners at Phoenix Perinatal Associates have delivered more than 40 sets of quadruplets and 200 sets of triplets - accomplishments believed to be world records.

That's why Cimoch traveled to Phoenix, hundreds of miles from her home and her husband in California.

The Tocolytics Debate:
Dr. Michael Greene of Massachusetts General Hospital insists there is no reason to use tocolytics. Such drugs don't prolong pregnancy, he asserts, adding that there can be life-threatening complications, including accumulation of fluid in the lungs. Dr. Elliott warns his patients about this risk.

One patient, Kelly, who asked that her last name not be used, experienced adverse symptoms when Dr. Elliott gave her magnesium sulfate. Her problem, known as pulmonary edema, was serious but is generally not life-threatening and can be treated, he says.

Dr. Greene says that studies have shown that women carrying quadruplets have a better chance of having surviving babies if they practice selective reduction to twins.

Cimoch's pregnancy stretched for about 33 weeks. That's almost four weeks longer than the typical quadruplet pregnancy in this country. Dr. Elliott said that those extra weeks will greatly benefit the babies' health. But he admitted such pregnancies can come at a great sacrifice to the mothers.

Dr. Elliott prescribes aggressive doses of highly controversial drugs called tocolytics, which help stop contractions but can be accompanied by major side effects. "It's more harsh than you could ever imagine," Cimoch said.

For two weeks Cimoch took a tocolytic called magnesium sulfate. It slowed down her heart, made her disoriented and brought on unbearable ot flashes. Yet Dr. Elliott believes that tocolytics are what enabled Cimoch to make it so far. "I just pray to God the babies will be healthy," she said prior to her delivery.

Her husband arrived in Phoenix barely in time for the big day. Almost 20 doctors and nurses participated in Cimoch's delivery by caesarian section. As the first baby, Alexis, was born, Cimoch cried tears of joy. Next came Paul, named for his father, and then Justin and finally Cole.

At one point Paul stopped breathing. Ten minutes later, the doctors were able to arrange for him to breathe on his own. Breathing trouble is common with multiple births. Almost always born premature, the babies' lungs may not be fully developed.

Seven weeks premature, all four Cimoch babies ended up in intensive care. The three boys weighed only about 3 pounds each. Justin's entire hand was no bigger than the tip of his nurse's thumb. Barely 2 pounds, Alexis was small enough to fit in an adult palm.

"You go through such a struggle, and when you see those little faces, it's all worth it," Cimoch said.

In six weeks the four babies were finally ready to travel to California. Justin and Cole made the trip on a medically equipped plane, without their mother. After arriving in California, Justin and Cole journeyed to yet another hospital.

Less than a week later, the Cimoch family was reunited. The medical cost of caring for the new mother and her quadruplets is expected to reach close to a million dollars. Insurance will cover most of that.

The four Cimoch babies have been home almost two months now. Some experts say, however, about 20 percent of premature babies develop severe disabilities such as cerebral palsy within their first five years.

Cimoch remains hopeful. "They're hitting their three-month birthday and, according to the poundage and weight charts, they're thriving very, very well," she said.

Email The Doctor:
Want to get in touch with Dr. John Elliott? Email jelliott@perinatal.com
She does worry about physical challenges ahead. But for now, the greatest issues are logistical. It takes a team of church volunteers, family and friends just to help Cimoch keep up.

Would she do it again? "I would do it again, but I wouldn't want to do it again," she said, laughing. "When I look athose children, they're healthy and vibrant, and I can't really look back and think what might it have been like if I didn't go."

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