Le stress foetal survenant au terme de la grossesse, lié au pic de production de la corticotropin releasing hormone, considérée comme l’horloge  placentaire, est le déclencheur spontané du travail d’accouchement par stimulation de l’axe corticotrope. Ce mécanisme, cependant, par défait de  synthèse de l’hormone adrénocorticotrope secondaire à l’aplasie hypothalamo-hypophysaire fait défaut chez le foetus anencéphale. En effet,  l’anencéphalie s’accompagne presque toujours du dépassement de terme de la grossesse en absence de l’hydramnios. Par contre, associée à ce  dernier, elle conduit à un accouchement prématuré. Nous rapportons un cas de déclenchement spontané du travail d’accouchement sur une  grossesse de trente-huit semaines et un jour. La gestante avait une circulation veineuse collatérale au niveau de la paroi abdominale, la hauteur  utérine était de 41 centimètres, l’échographie réalisée avait objectivé un foetus anencéphale associé à un polyhydramnios. Le nouveau-né était  décédé sept minutes après l’accouchement. Ainsi, bien que très rare, l’anencéphalie associée au polyhydramnios peut atteindre le terme de la  grossesse. L’échographie du deuxième trimestre devrait être réalisée chez toute les gestantes pour dépister cette malformation et arrêter l’évolution  de la grossesse, car cette pathologie est incompatible avec la vie extra-utérine.   English title: Spontaneous induction of labor in a full-term pregnancy of an anencephalic fetus: an unusual case report The fetal stress occurring at the end of pregnancy is linked to the peak of corticotropin-releasing hormone which is considered as the marker of  placental clock. This stress is the spontaneous trigger of labor by stimulation of the corticotropic axis. In the anencephalic fetus, this mechanism is  lacking due to the absence of synthesis of adrenocorticotropic hormone secondary to hypothalamic-pituitary aplasia. In fact, anencephaly is almost  always accompanied by the post-term pregnancy in the absence of hydramnios. However, when associated with hydramnios, it leads to premature  delivery. We report a case of spontaneous induction of labor in pregnancy of thirty-eight weeks and one day. The pregnant woman had a collateral  venous circulation in the abdominal wall, the uterine height was 41 centimeters, and the ultrasound scan showed an anencephalic fetus associated  with polyhydramnios. The newborn died seven minutes after delivery. Therefore, although very rare, anencephaly associated with polyhydramnios  can reach term. The second-trimester ultrasound should be performed in all pregnant women to detect this malformation and stop the evolution of the pregnancy because this pathology is incompatible with extrauterine life.

Introduction: Induction of labor has become an increasingly utilized obstetric intervention in developed countries. It contributes to reduce the maternal and perinatal morbidity and mortality. Dinoprostone derivatives are often used under cardiotocography. In poor countries, health structures have neither fetal monitoring, nor means of preserving Dinoprostone derivatives. Misoprostol therefore constitutes an alternative. This study seeks to establish the efficacy and safety of oral Misoprostol and to assess maternal and perinatal prognosis in an area with limited resource. Methods: This is a multi-center clinical trial, conducted in 3 hospitals centers in Kisangani, Tshopo Province/Democratic Republic of Congo from December 1, 2020 to May 31, 2021. Our sample was constituted with 68 pregnant women with term pregnancy. Fifty micrograms of Misoprostol was administered orally. The data were collected prospectively, their encoding was carried out on an Excel sheet 2013 and their analysis carried out using the EPI INFO software. Results: The average age of the pregnant women was 23.17 ± 5.76 years. The average parity was 1.02 ± 1.2. The average body mass index (BMI) was 24.98 ± 2.55 Kg/m 2 . 66 (97.1%) patients had received a maximum of 3 doses of Misoprostol. Out of the 16 parturients who received 3 doses or more, 11 (68.8%) had a BMI ≥ 25. The average duration of labor was 16.03 ± 7.99 hours. 66 (97.1%) pregnant women had delivered vaginally. 57 (83.8%) patients delivered within 24 hours. Out of the 11 patients who delivered after 24 hours, 7 (63.6%) had a BMI ≥ 25. The induction failure rate was 2.9% (2 patients). 2 (2.9%) fetuses had presented pathological modification of fetal heart rate (FHR). 2 (2.9%) patients had undergone cesarean section. Conclusion: Labor