Acephalic Nigerian newborn: A case report

Abstract

Background: Acephaly is one of the numerous cephalic disorders in the newborn. It simply means “no head.” The condition is one of the most difficult to explain, very rare and lethal anomaly. Most reported cases of acephalic fetuses are usually found in the monochorionic twin gestation.

We present a 34 year old woman who was pregnant for the sixth time. She had given birth to two infants previously; the first, a girl, born in the year 2006, weighed 2.8 kg, the second was a boy delivered in the year 2009 and weighed 3.2 kg, both children were entirely normal. She then had three serial spontaneous abortions at 11 weeks, 9 weeks and 13 weeks respectively. She presented with the sixth pregnancy in year 2016 at gestational age of 38 weeks and 2 days, she had not started antenatal care in any hospital until the day of presentation in the Basic Health Centre where she complained of drainage of liquor of 18 hours duration and occasional labour pains. At the peripheral centre, a diagnosis of malpresentation was made and she was subsequently referred to our centre. The medical history revealed that she had two episodes of febrile illness in the first trimester and each time, she was treated by a ‘nurse’ beside her house. She was treated with some oral medications which names she was not aware of. No history of herbal concoction ingestion. In our centre, an urgent bedside obstetric scan was done which revealed multiple congenital abnormality with no visible cranium. Laboratory tests such as complete blood count, retroviral and hepatitis B & C screening were done, two units of blood was cross matched standby and she was delivered by Caesarean section.

Keyword: Acephalic, Newborn