A newborn baby presenting with pulsatile mass in the upper abdomen. Examination revealed exomphalos major with part of cardia in it. X ray showed absence of lower sternum with herniation of heart in to the sac of exomphalos. Echocardiography revealed Tetralogy of Fallot. Antenatal sonogram {level 1} done at a peripheral centre in the second trimester was reported as normal
