Summary A case of botulism is reported in a heroin‐abusing parturient who initially presented with lethargy and slurred speech. The diagnostic difficulty, complications, intensive care and anaesthetic management of this case are discussed, with particular reference to the pregnancy and the effects of both botulism and its empirical treatment on the fetus. A short review is provided of a condition that has seen a marked increase in its incidence since 2000.

Fetus in Fetu is a rare congenital anomaly in which monozygotic twin is incorporated into its sibling during development. It is a lesser known disease even in the medical community as less than 200 cases have been reported. Some theories have been proposed regarding the pathogenesis of fetus in fetu and clinical manifestations of fetus in fetu vary. It should be differentiated from teratoma which has no axial arrangement and has got definite malignant potential. Herein, we describe a 5month old boy with an abdominal mass. After ultrasound and CT scan, provisional diagnosis of Fetus in fetu causing bilateral moderate hydroureteronephrosis was made. Elective laparotomy revealed a well encapsulated retroperitoneal mass which was successfully excised. Complete excision of fetus in fetu is curative. The rarity of this case is the reason why we deem our case reporting.

Poster abstracts pregnancies including a detailed morphological scan, additionally the investigation of the four chamber view and the leftand right ventricular outflow tracts. From this group, in 585 singleton pregnancies second-trimester-screening at 18-22 weeks was performed. The perinatal outcome (mode of delivery, birth weight, Apgar score, umbilical cord pH and perinatal mortality) of 570 cases was recorded. Results: The median maternal age of the 603 cases was 31 (range, 16-44), the median gestation at first-trimesterscreening was 12 + 6 (11 + 1 to 13 + 6) weeks and the median gestation at second-trimester-screening was 19 + 2 (18 + 0 to 21 + 6). Nineteen (3%) of the 603 fetuses had a chromosomal abnormality. Of the 603 fetuses had twenty a termination of pregnancy, 6 a spontaneous abortion and 7 an intrauterine fetal death. 44 of the 603 fetuses had 88 structural abnormalities considered as being detectable by sonography. 6 fetuses of the 570 with perinatal outcome had a chromosomal abnormality (2x 47XXY and 4x other) and 21 fetuses had 31 structural abnormalities detected at first-and second-trimester-screening. However, parameters of initial neonatal adaptation did not differ significantly. Conclusion: First-trimester screening leads to an early identification and selection of pregnancies with adverse outcome. Fetuses with structural abnormities are regarding the early neonatal period and postnatal adaptation comparable to healthy newborns.