Case report: 19 years old PG married for 1 year, her husband is her cousin. No family history of congenital anomalies, No significant past medical history nor drug history. She as referred for anomaly scan, the pregnancy was uneventful till referral she was on good antenatal care received folic acid supplement. Ultrasound findings: Single, viable, breech presentation. Posterior high placenta Anhydramnios GA by ultrasound 26+3days (HC:28+6, FL:24+3, AC: 24+4) Congenital anomalies: Hydrocephalus (severe ventriculomegaly measuring 22cm, normal is <10cm Dilated third ventricle (6mm) thalami are not seen well. Both kidneys show features of multicystic changes No cortico-medullary differentiation. Bladder filling is not seen Conclusion A picture suggestive of bilateral non-functioning kidneys. Hydrocephalus. No major anomaly seen however other anomalies can’t be excluded due to poor visualization. Impressionvery poor outcome.