• Hari Kishor Shrestha, Suphatra Koirala, and Ingima Shrestha.
• Department of Radiology, Om hospital and Research Center, Chabahil, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2021 Apr 30; 59 (236): 396-398.

AbstractAnencephaly is a condition in which there is an absence of skull and brain tissues. Absence of cranial vault mainly results because of defective neurulation. Absence of cerebral tissues may cause diminished heart size, due to decreased heart load causing various cardiac abnormalities. Here, we report a case of a primigravida lady at 17 weeks of gestation with misoprostol induced expulsion of fetus after ultrasonography revealed absence of brain tissue and calvarium above the orbits suggesting anencephaly. A 300g fetus was delivered which confirmed the ultrasound findings. The patient was discharged with advice for intake of folic acid beginning from 3 months before conception in future pregnancies. Neural tube defects can manifest within approximately 28 days of gestation which highlights the importance of oral folic acid intake before pregnancy.

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