Dilemma of Labor Management in Lethal Anencephalic Fetus

Anencephaly is a congenital anomaly of the central nervous system, caused by a disruption in brain and skull development of a fetus, which includes the disruption of the cerebral hemispheres, cerebellum, spinal cord, and pyramidal tract. This is a lethal condition that most fetuses born with this condition cannot survive after being delivered. The prevalence of this condition is 1 in 1000 deliveries. Early detection through prenatal ultrasound testing is essential to make a correct and precise plan for managing the pregnancy and delivery process, thus avoiding potential maternal complications. We reported a 33-year-old pregnant woman who was diagnosed with having anencephalic fetus at 24 weeks of pregnancy. The patient has been informed about this condition and offered a termination, but she refused to do so and is willing to continue the pregnancy. Induction of labor was planned at 40 weeks of pregnancy, but the process was impaired, so a cesarean section was performed to save the mother. The baby was delivered with anencephaly, as shown by the ultrasound result, and died 2 days after being delivered. The mother recovered well and was given education about the importance of folic acid intake for the next pregnancy. Conclusion of this case was labor management of anencephalic fetus was planned according to medical indication, with a special individual approach due to the obstetric condition. Yet, the delivery method should be based more on the mother's condition rather than the baby's, including the maternal emotional factor.