Background: Heterotopic caesarean scar pregnancy (HCSP) is where one gestational sac implants in the previous caesarean section (CS) scar and another sac implants in the uterine cavity. There is limited evidence on the management of this rare condition. Here, we present a case of HCSP in which US-guided selective reduction of the CS pregnancy (CSP) was performed using potassium chloride (KCl) to salvage the intrauterine pregnancy. We also conducted a review of published case reports to understand the determinants of outcome. Methods: After a MEDLINE search, 23 case reports were found eligible based on quality assessment and were included in the analysis. A composite-score indicating overall obstetric morbidity was computed, and mixed-effects linear regression was implemented to identify its predictors. Results: US-guided local treatment was the most common mode of intervention for HCSP. The regression analyses revealed that the poor obstetric outcomes, especially antepartum haemorrhage (APH) and postpartum haemorrhage (PPH), were significantly predicted by advanced gestational age at treatment and a higher number of previous CS, irrespective of the mode of treatment. Conclusion:These results indicate that a high index of suspicion for an early ultrasound diagnosis and treatment is critical. USguided techniques are useful in salvaging the intrauterine pregnancy with decreased maternal morbidity. The results are preliminary due to the rarity and a small number of published reports. Every CSP should be recorded in a central international registry to obtain reliable data on the diagnosis and management of women with CSP. Given the rising rates of CS, future systematic studies are warranted.

Sirenomelia is a very rare congenital developmental disorder of the lower extremities, and all the other derivatives from the caudal mesoderm, mainly the viscera i.e. kidneys, gonads and hindgut. In the majority of cases, it is incompatible with life in the neonatal period as it is associated with renal agenesis. The importance of detecting this anomaly in the first trimester lies in this lethality in order to offer the option of termination of pregnancy at an earlier gestation. Appropriate counselling at diagnosis is essential to give the couple a clear picture of what they might expect postnatally regarding the renal anomalies or the many surgeries which might be required for the lower limbs and viscera. We present a case series (n = 5) diagnosed by ultrasound at our center between January 2014-2020. Through this brief article, we aim to give a key to the antenatal diagnosis of this rare anomaly, an aid on how not to miss it and its subsequent management.

Genu Recurvatum is a rare congenital anomaly involving the knees. Most of the cases are sporadic, and if isolated, carry a good prognosis. Syndromic association tend to be present, and if so, the diagnosis becomes important. Early diagnosis and counseling remain the key as the couple can make an early decision on the pregnancy. Proper counseling would also help the couple in knowing what to expect postnatally. One, or maybe more than one, surgeries may be required for its correction and the gait may never be completely normal. We present a case series diagnosed by ultrasound at our center between January 2014 and 2020. Through this concise article, we aim to give a key to antenatal diagnosis and postnatal management of this rare condition.