Two Case Reports of Anencephaly Diagnosed Before Birth *

Anencephaly is one of the most frequent type of all fetal monstrosities. Sprangler7, who studied 11,52i births, has reported the incidence of anencephaly as I in every goo, or approximately O.1 per cent. The condition was not successfully diagnosed previous to labor until 1917, when Case2 reported such a monstrosity, recognized roentgenologically before the onset of labor. Since that time there have been an increasing number of such reports. In I926, Case' reviewed the literature, citing cases reported by Sprangler, Campbell, Willets and Anderson, and adding four more cases with histories and roentgenograms. More recently Jennings5 and Beath' have reported such anomalies. As to the etiology of this condition nothing conclusive has been offered. The theories are concerned chiefly with defective fertilization, defective maternal environment, or defective germ cells. Polyhydramnios is usually present in such conditions and just what influence, if any, it may have on this anomalv is still debatable. It is of interest to note that a family prevalence of anencephaly has been reported by Thoms8, whose patient gave birth to three anencephalic fetuses occurring in succession. However, such a family prevalence is quite rare. A positive diagnosis of anencephaly before the onset of labor can not be made without an adequate radiological examination. Many physical signs, as palpation to determine faulty character of the cranium, exaggerated spasmodic and convulsive movements of the fetus, existence of polyhydramnios, thickening of the skin on the mons veneris and vicinity, etc., have been discussed by various authors as significant aids in diagnosis. Although many cases have been recognized intra vitam after the onset of labor by examining per vaginam, it is most important to make such a diagnosis as early as possible, so that pregnancy may be terminated and the mother spared the many trials of continuing pregnancy, and the chagrin of delivering a monster at term. Such a diagnosis can usually be made