Abstract
Fetal hydrocephalus detected antenatally presents challenges in management and prognostication, necessitating careful consideration of therapeutic intervention. We report a case of 22 year old primigravida at 35 weeks gestational age with a diagnosis of isolated gross hydrocephalus in a single live intrauterine fetus. Following thorough counselling and consent, the patient underwent fetal cephalocentesis due to maternal contraindications for cesarean section. Under ultrasound guidance and local anesthesia, cerebrospinal fluid was drained. The procedure was well tolerated by both mother and fetus without immediate complications .Post procedure monitoring revealed a reduction in fetal biparietal diameter and alleviation of ventricular distension. This case, underscores the feasibility and potential benefits of fetal cephalocentesis in selected cases of antenatal hydrocephalus, despite the associated neurodevelopment risks and postnatal complications that warrant ongoing monitoring and multidisciplinary care.
It also highlights the successful management of isolated gross fetal hydrocephalus through prenatal intervention, emphasizing the multidisciplinary care for maternal and child health care.

Key words: Fetal hydrocephalus , Cephalocentesis, Ventriculoamniotic shunting