ABSTRACT
OBJECTIVE:To discuss the clinical strategies of prenatal counseling in cases with abnormal maternal uterus cavity and misshapen fetal head detected in the third trimester.METHODS:The cases with both maternal uterus malforma⁃tion and ultrasound-diagnosed microcephaly only at the third trimester between 2016 and 2017 were reviewed and the postnatal development of the infants was followed up.RESULTS:A total of two cases were recruited and both cases showed normal fetal structure at the second trimester anomaly scan.One case was noted to have board thick fibromuscular adhe⁃sions band.The fetus was in breech presentation with limited fetal movement of the lower limbs.Amniocenetesis revealed normal karyotype of the fetus.At the 31 st week of the gestation,the fetus appeared to have elongated head with head cir⁃cumference(HC)at-2 SD level,protruding upper lip,and unilateral club foot.The other pregnant woman had complete uterine septum with fundus-located placenta and breech presentation.Her fetus had a HC below-4 SD whereas the dis⁃tance between the cranial bottom to top was 88 mm,with caput succedaneum and oligohydramnios.Magnetic resonance im⁃aging(MRI)showed normal structure and sulci gyrus development of the fetus.Both babies were born prematurely(at36 th and 31 st week)with birth weights compatible to their gestational ages,and both had an obviously misshapen head at birth.One baby also had unilateral club foot.The babies' appearance and development were totally normal at a follow-up examination at 6 months after birth.CONCLUSION:The prognosis of cases with uterine cavity abnormality and misshapen fetal head detected only at third trimester is usually good,but there is increased risk of malpresentation and preterm la⁃bor.Comprehensive assessment of the serial fetal growth conditions,maternal uterus abnormalities,and MRI are helpful in prenatal counseling.