Introduction The incidence of ectopic pregnancy is up to four times higher after in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) than in spontaneous pregnancies, and the risk of ectopic pregnancy is increased by tubal factor infertility and the transfer of multiple embryos. However, the effect of embryo quality on the probability of ectopic pregnancy has not been investigated until now and it is not clear whether ovarian stimulation parameters affect the incidence of ectopic pregnancy. Material and Methods An historical cohort study of 15 006 clinical pregnancies (diagnosed by ultrasound at 6–8 gestational weeks) after non‐donor IVF/ICSI with fresh embryo transfer (n = 8952) or frozen–thawed embryo transfer (n = 6054). Treatments were performed during 2000–2017 in Finland. A total of 9207 (61.4%) single and 5799 (38.6%) double embryo transfers of no more than one top‐quality embryo were evaluated. We analyzed the effects of multiple factors on ectopic pregnancy by logistic regression, including type of cycle (fresh vs frozen embryo transfer), female age, number and quality of embryos transferred, tubal factor infertility and factors of ovarian response to gonadotropin stimulation. Results Ectopic pregnancy was observed in 2.3% of cycles. There was no significant difference in ectopic pregnancy rate after fresh embryo transfer and frozen embryo transfer (2.2% vs 2.4%, p = 0.3). The ectopic pregnancy rate was lower in cycles with top‐quality embryo transfer (1.9%) than of those where only non‐top quality embryos were transferred (2.7%, p < 0.0001). Tubal factor infertility was diagnosed more often in ectopic pregnancy than in intrauterine pregnancies (21.2% vs 11.0%, p < 0.0001). Logistic regression revealed lower odds for ectopic pregnancy after a top‐quality embryo transfer than after transfer of a non‐top quality embryo (odds ratio [OR] 0.72, 95% confidence interval [CI] 0.56–0.92, p = 0.007). Transfer of two vs one embryo (OR 1.35, 95% CI 1.05–1.70, p = 0.02) and tubal factor infertility (OR 2.21, 95% CI 1.68–2.91, p < 0.0001) significantly increased the risk of ectopic pregnancy. Conclusions Transfer of non‐top quality embryos is associated with a higher rate of ectopic pregnancy. This is particularly important to keep in mind in treatments with only non‐top embryos available even in the absence of tubal factor infertility. To minimize the risk of ectopic pregnancy, the number of embryos transferred should be as low as possible.

Spina bifida is a neural tube defect that occurs in about 1 in 1,500 pregnancies. Open spinal defects are associated with paralysis, incontinence and hydrocephalus requiring postnatal shunting of the cerebrospinal fluid. Neural tube defects are preventable through preconceptional folic acid supplementation. Occasionally, the diagnosis is made during routine anomaly scan at 18-20 weeks of gestation, as the earliest signs of the anomaly can be seen at the end of first trimester. The information provided by ultrasound plays a crucial role in patient counseling and pregnancy management. The authors report a case of prenatal diagnosis of spina bifida aperta with focus on detailed ultrasound presentation and difficulties in consulting in relation to the prognosis for the newborns.

BACKGROUND: Cervical gestations are rare potentially life-threatening conditions. Although these can cause massive hemorrhage, most of them abort during the first trimester without having been diagnosed. However, cervico-isthmic pregnancies are more likely to persist to an advanced gestation in the second and third trimester owing the need for hysterectomy due to defect placentation. CASE PRESENTATION: We presented a rare case of cervical pregnancy after donor egg in vitro fertilization procedure, with no previous pregnancies, medical, and surgical history. Our patient rejected early termination of pregnancy at 5 gestational weeks. Pregnancy continued until 16 weeks when she was hospitalized and terminated due to medical grounds with curettage. Post-operative period was uneventful until day 20, when she was admitted with suspicion of retained placental tissue and endometritis. A hysterectomy was done with blood transfusion due to excessive blood loss. Histologic examination confirmed placenta accreta spectrum disorder. CONCLUSION: Cervical pregnancy can be treated conservative if timely diagnosed by early ultrasound, which can reduce the chances of severe life-threatening hemorrhage necessitating hysterectomy or blood transfusion.