Monochorionic-monoamniotic (MCMA) twin pregnancy discordant for anencephaly is a rare occurrence. Management of such cases using Selective reduction versus expectant management is itself a questionable topic. We report such a case managed expectantly with successful outcome. A 26 year old primigravida woman was referred to us with MCMA twin pregnancy discordant for anencephaly at 21+2 weeks of gestation. She opted for expectant management till 34 weeks and elective cesarean section was performed. Healthy neonate without any congenital malformation was 2.1Kg and required 4 days of NICU care. Neonate with anencephaly weighing 1.4Kg succumbed after 22 hours of life. This report emphasizes the option of expectant management for such a rare condition.

Dr. Chameli Subbaraj, MBBS, DNB (OBG), MRCOG, is a dedicated medical professional with over five years of experience in the field of Obstetrics and Gynecology. She has been actively involved in providing comprehensive women’s healthcare, with a special focus on maternal and reproductive health. Currently, Dr. Subbaraj serves as a Specialist Registrar in Obstetrics and Gynecology at Basildon University Hospital, United Kingdom. Her commitment to patient care and continuous learning reflects her passion for advancing women’s health and contributing to clinical excellence in her field.