Labor in a Woman With Prune Belly Syndrome

Abstract

Pregnancy and labor in patients with Prune Belly syndrome (PBS) have only been described in three cases in the literature. In these case reports, two patients had elective cesarean section due to PBS and consequences of the syndrome. One patient attempted vaginal delivery, had a prolonged second stage of labor and delivered by vacuum-assisted delivery. We aimed to investigate the feasibility of vaginal delivery in women with hypoplastic abdominal muscles without the need for instrumental or operative intervention. We report a patient with PBS, only affecting the abdominal muscles, who attempted vaginal delivery. Due to prolonged second stage of labor and exhaustion and after being fully dilated for 3 h with no evident progression, an emergency cesarean section was performed. The second stage of labor involves coordinated uterine contractions and voluntary maternal efforts. Impairment of the second stage of labor can occur if the woman is unable to effectively push, due to factors such as hypoplastic abdominal muscles. This inability to generate sufficient intra-abdominal pressure can lead to prolonged labor, increased risk of fetal distress, and the potential need for instrumental delivery or cesarean section to ensure the safety of both the mother and the fetus. Our case supports the thesis that patients with PBS may experience prolonged second stage of labor and need assisted instrumental or operative delivery. Whether it is possible for a patient with PBS to deliver vaginally without instrumental or operative interference is yet unknown.

J Clin Gynecol Obstet. 2024;13(2):51-53
doi: https://doi.org/10.14740/jcgo967