Late Prenatal Diagnosis of Dandy-Walker Malformation: A Case Report from Sudan Amidst the COVID-19 Pandemic

Dandy-Walker malformation (DWM) is a rare congenital anomaly of the posterior fossa, often detectable via prenatal neurosonography. In low-resource settings, delayed diagnosis remains a challenge, especially during healthcare disruptions such as the COVID-19 pandemic. We report a case of DWM diagnosed at 36+5 weeks gestation in a Sudanese patient with limited access to structured prenatal screening. Initial scans were undocumented, and the anomaly was missed until late gestation. Despite multidisciplinary counseling and planned delivery, intrauterine fetal demise occurred at 39+4 weeks following reduced fetal movement. Postnatal imaging confirmed classic DWM features, including vermian hypoplasia and fourth ventricle cystic dilation. This case underscores the critical need for standardized fetal neurosonography and structured screening protocols in antenatal care. Early detection of CNS anomalies enables timely counseling, delivery planning, and neonatal preparedness—especially vital in resource-constrained environments. Early neurosonography and structured screening protocols are essential to mitigate adverse outcomes in congenital CNS anomalies.