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Poster: ?Introduction ? Congenital hydrocephalus is characterized by an excessive accumulation of cerebrospinal fluid in the brain's ventricles due to an imbalance between the CSF synthesis and absorption. ?Case history ? A 23-year-old lady who had amenorrhea for two months visited our department for antenatal checkup. She gave a history of congenital hydrocephalus and VP shunt placement for the same, during the assessment. She was diagnosed with congenital hydrocephalus during an evaluation for delayed milestones and macrocephaly at 5 months of age, and a right ventriculo-peritoneal shunt was installed. At 9 years of age, she had appendicular perforation with peritonitis and Enterococcus shunt infection, treated conservatively. A left VP shunt was made later and she was asymptomatic since then. MRI brain was advised by neurosurgery in second trimester considering her medical background, however not performed. She underwent McDonald's cervical encerclage for short cervix at 14 weeks detected in NT scan (removed at 37+2 weeks). At 39 weeks, she presented with frontal headache and intermittent lower abdominal pain. A screening MRI brain was performed suspecting shunt channel collapse, however reported normal. At 39+3 weeks, she underwent emergency LSCS for second-stage arrest of descent following induction for prolonged latent phase, delivering a healthy boy (weight- 3.066 kg). Intraoperative findings The anterior wall of the uterus was adherent to parietal pertioneum and rectus muscle. Post-operative period was uneventful, and hence was discharged on day 4 with OBG and neurosurgery follow-up. ?Discussion? Congenital hydrocephalus is an uncommon condition complicating pregnancy with both maternal and fetal side-effects, with increased risk in its active stage. However, most cases have an uncomplicated outcome with a multidisciplinary approach, and hence vaginal delivery is preferred. Partial shunt obstruction, common in late pregnancy, responds to conservative treatment.