A preterm baby weighing 1.6 kg was delivered vaginally at 34 weeks gestation by a 23-year-old primigravida with an unsupervised pregnancy. Postpartum investigation revealed the presence of diabetes mellitus. There was no history of drug intake and radiation exposure. The Apgar score was 3 at 1' and same at 5 min following which the baby was shifted to neonatal intensive care unit, but died 12 h postbirth due to severe respiratory distress. There was very scanty amniotic fluid drained at the time of delivery. The new born baby had gross anomalies like narrow chest indicating lung hypoplasia, fused both lower limbs and feet with 10 toes, absence of external genitalia, imperforate anus and single umbilical artery [Figures 3 and 4]. Examination of the fused lower limbs showed the presence of all thigh and leg bones thus classifying our patient as Type I of Stocker and Heifetz classification. The infant also had features of Potter's facies including prominent infraorbital folds, small slit-like mouth, receding chin, downward curved nose, and low-set ears. Ultrasonography revealed bilateral renal agenesis. On autopsy, there was an absence of both kidneys, ureters, urinary bladder, seminal vesicle, and urethra. The gastrointestinal system ended in a blind loop at the rectosigmoid area and was filled with meconium. Two pea sized gonads suggestive of testes were seen bilaterally posterior to pubis. Right pneumothorax with collapsed right lung was evident. Examination of brain, heart, liver, adrenal glands, and pancreas revealed normal anatomy.