Jarcho-Levin syndrome (or spondylothoracic dysplasia) is a congenital disease characterized by multiple vertebral and rib malformations, causing a short trunk dwarfism commonly leading to respiratory insufficiency and death during the first years of life. Prenatal sonographic diagnosis of Jarcho-Levin syndrome has been reported in both the first and second trimester. But always in families at risk. The most characteristic sonographic features were malaligned vertebrae, disorganization of vertebral bodies, and posteriorly fused ribs. We describe a case diagnosed during the second trimester ultrasound scan for screening of fetal anomalies in a couple without history of affected children. This was the first pregnancy of a 24-year-old woman. The course of the pregnancy was uneventful until a structural defect of the fetal spine was detected at the 20 weeks' scan. Fetal karyotype by cordocentesis was 46 XY, and major cardiac malformations were excluded by detailed fetal echocardiography. The fetus had a severe disorganization of the spine and ribs, skeletal kyphosis, with several hemivertebrae and a small thorax. The ultrasonographic findings allowed us making a reliable diagnosis of a variety of Jarcho-Levin syndrome, and adequate genetic counselling to the couple, even though no other malformations were associated and there was no family history for the syndrome. All of the findings at postmortem examination confirmed the ultrasound features and were consistent with the Jarcho-Levin syndrome. Our case illustrates the importance of an accurate ultrasound examination at both first and second trimester in order to detect any rare congenital syndromes. Background: Cervical pregnancy is rare, but potentially lifethreatening. With ultrasonography, early diagnosis and hereby medical management become possible. The combination of mifepristone and methotrexate for the treatment of ectopic pregnancies has been shown to be effective, with a shorter resolution time compared to methotrexate alone. The Mirena coil is an intra-uterine contraceptive device, releasing 20 µg of levonorgestrel daily into the uterine cavity. The incidence of ectopic pregnancies is 0.02 (compared to 1.2-1.6 without contraception). This is the first report of a viable cervical pregnancy in a patient using a levonorgestrel containing intrauterine contraceptive device (LNG-IUCD). Case report: A 37-year-old G3P2 with a Mirena coil, presented with vaginal bleeding and subjective pregnancy symptoms. On transvaginal ultrasound a cervical pregnancy was diagnosed. On Doppler examination strong vascularisation was documented around the gestational sac (16 × 17 mm), containing an embryo with CRL of 9 mm and visible heart beat. Serum beta-human chorionic gonadotropin (b-HCG) level was 35.870 IU/L. She was administered four doses of methotrexate I.M. at 1 mg/kg, 48 hours apart, each followed 36 hours later by folic acid rescue I.M. at 0.1 mg/kg. On follow-up ultrasound, fetal heart activity persisted and b-HCG level rose to 47.310 IU/L. Therefore mifepristone, 600 ...