Introduction: Fetal spinal and spinal cord anomalies are relatively uncommon, representing a small proportion of all fetal abnormalities detected both prenatally and postnatally. Early detection is crucial, as these malformations can lead to severe complications, including motor deficits, or may be lethal.

Clinical Case: We report a 35-year-old gravida 3, para 2 woman with no significant medical history, evaluated at 20 weeks of gestation. No first-trimester ultrasound had been performed. Ultrasound at 20 weeks revealed a 2.5 cm lumbosacral myelomeningocele, a small posterior fossa, a reduced cephalic pole, ventriculomegaly, and bilateral clubfeet. Given the presence of a poly- malformative syndrome and strong suspicion of Chiari type II malformation, termination of pregnancy was recommended.

Conclusion : Malformations of the central nervous system can be life-threatening, either directly or through associated    complications, particularly motor deficits. Prenatal ultrasound plays a pivotal role in the early detection of these anomalies, enabling timely diagnosis and appropriate management decisions. Early identification also allows for informed counseling and optimal perinatal care planning

Dr. Anas Selmi is a resident in Obstetrics and Gynecology at the Ministry of Public Health in Tunisia. He completed complementary certificates in Senology. His residency training includes rotations in Obstetrics and Gynecology at Sidi Bouzid University Hospital , Mongi Slim University Hospital in Tunis, and Kasserine University Hospital. He has participated in national and international gynecology and obstetrics conferences, including AGOB and STGO.