A NEGLECTED CASE OF ANENCEPHALY

Abstract

Introduction. Anencephaly is a neural tube defect (NTD) that occurs when the cephalic end of the neural tube fails to close. With five cases per 10,000 births, it is the second most common NTD worldwide. Case report. A 23-year-old woman with third pregnancy was hospitalized at the Pathological pregnancy department, University Clinic for Obstetrics and Gynecology in Skopje. Her pregnancy course had been irregularly controlled, without taking any folic acid in preconception or in the first trimester. The patient had not attended PRISCA 1 or 2, vaginal smear or microbiological examination, ultrasound examination or other obstetric examination of any kind up until her 20th week of pregnancy. The very screening of fetal structural anomalies showed acrania and anencephaly. Termination of pregnancy had been suggested, nonetheless the patient had decided to carry on with the pregnancy. After passing her term, she underwent induction of labor. Vaginal delivery was without any complications. The infant was in a clinically difficult condition, with hypotony, cyanosis and major congenital absence of the cranial bones. Regardless of the post-partum palliative treatment, the newborn died at H23 of life. Conclusion. The root of the possibilities of early detection of anencephaly, detailed examination and opportunity for optimal perinatal management lays in the sonographic technology and its advances. That aside, as physicians, we had to respect our patient's decision to take any desired action considering her circumstances.