Anencephaly is a severe congenital condition where a major portion of the brain, skull, and scalp fails to develop properly during early fetal development. This defect occurs when the neural tube, which forms the brain and spinal cord, does not close completely at the top end. The complications of anencephaly are profound and affect virtually every aspect of the infant’s survival and quality of life.
The most immediate and devastating complication is that infants with anencephaly are born without large parts of the brain, especially the forebrain and cerebrum, which are responsible for thinking, coordination, and sensory processing. Because these critical brain structures are missing or severely underdeveloped, the infant cannot sustain basic life functions independently. This results in an inability to breathe, regulate body temperature, or feed normally. Most babies with anencephaly are either stillborn or die within hours to days after birth due to these life-sustaining failures.
In addition to the absence of brain tissue, the skull and scalp are often missing or incomplete, leaving the brain exposed to the amniotic fluid during pregnancy and to the external environment after birth. This exposure increases the risk of infections and trauma, further complicating the infant’s fragile condition.
Because the brainstem, which controls some automatic functions like heartbeat and breathing, may be partially present, some infants might show reflex responses such as crying or spontaneous movements. However, these reflexes do not indicate consciousness or the ability to survive long-term. The lack of higher brain functions means there is no potential for cognitive development, awareness, or voluntary movement.
Other complications include severe facial and cranial deformities. The absence of the upper skull can cause the face to appear flattened or malformed. Sometimes, associated abnormalities such as cleft lip or palate may be present, complicating feeding and breathing even further.
From a medical management perspective, anencephaly presents profound challenges. There is no cure or standard treatment that can reverse the brain malformation. Supportive care focuses on comfort, managing symptoms, and addressing parental needs. Because survival beyond the neonatal period is extremely rare, medical interventions like mechanical ventilation or surgery are generally not pursued, as they do not improve outcomes and may prolong suffering.
Pregnancy complications related to anencephaly can also arise. The presence of a fetus with anencephaly may increase the risk of polyhydramnios, a condition where there is too much amniotic fluid. This can cause maternal discomfort, preterm labor, or other obstetric complications.
Psychologically and emotionally, the diagnosis of anencephaly is devastating for families. The knowledge that the infant will not survive long after birth, combined with the visible deformities, creates profound grief and requires sensitive counseling and support.
In rare cases where anencephaly is diagnosed prenatally, families may face difficult decisions regarding pregnancy continuation or termination. If the pregnancy is continued, careful monitoring and planning for delivery in a supportive environment are essential.
In summary, the complications of anencephaly are overwhelmingly severe and multifaceted. They include the absence of critical brain structures leading to inevitable death shortly after birth, physical deformities, inability to perform basic life functions, increased risk of infections, and significant emotional and medical challenges for families and healthcare providers. There is no treatment to correct the defect, and care is primarily palliative, focusing on comfort and dignity.
