The present case describes an acardiac, acephalic fetus, diagnosed by ultra-sound, during the 33rd gestational week of an insulin dependent diabetic parturient, who had developed toxemia gravida. The diagnosis had been confirmed by the autopsy. The differential diagnosis from an in-utero death of the second twin had been raised. The acardiac acephalic foetus is a rare congenital malformation observed during the monozygotic twin pregnancy. The second fetus being normal, our approach consisted in the clinical observation of the parturient, followed by cesarean section delivery the 4th day of the 36th gestational week to avoid worsening of toxemia gravida.
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