Interstitial pregnancy cases that advance to term, or near term, are occasionally reported. We present an unusual case of a third trimester interstitial pregnancy with antenatal diagnosis and expectant management. She presented at 20 weeks of pregnancy with an early preterm premature rupture of membranes, and expectant management was initiated. The ultrasound suggested an interstitial location and a posterior magnetic resonance image, obtained at 26 weeks, confirmed the diagnosis. Because of the risk of uterine rupture, an elective cesarean section was performed at 28 weeks. During the laparotomy, the uterine fundus appeared intact with an asymmetric bulge that provided evidence of placenta increta. The baby was delivered, and an obstetric hysterectomy was performed. The newborn was admitted to the neonatal intensive care unit with a severe respiratory distress syndrome. No response to mechanical ventilation was observed, and neonatal death was reported. A uterine pathological examination confirmed the diagnosis.

In a twin pregnancy of a 25-year-old woman one fetus was a normal male, while the other had hydrocephalus (6 mm thick pallium in the 23rd week) and a neural-tube defect in the thoracic-lumbar region. The abnormal fetus was removed by minor section in the 24th week, after which the normal one developed without complication. A healthy boy, weighing 3050 g and 52 cm long, was delivered spontaneously in the 39th week. Palpation of the uterus revealed a dehiscence, covered by muscle, in the region of the uterotomy scar, but it required no revision.

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The patient was referred to hospital in the 29th week of gestation owing to polyhydramnions. Ultrasonography revealed isolated left-sided hypertrophy (from foetal chest to the lower extremity) with subcutaneous lymph cysts. Amniocentesis for genetic examination revealed a chromosomal disorder showing homozygous t(13q, 14q) translocation. This extremely rare anomaly could be explained only and was finally proven by a father-daughter incest. The authors underline the necessity of karyotyping as well as the ultrasonic exclusion of foetal malformations in patients with polyhydramnions.

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