Vaginal delivery in a woman with prune belly syndrome: a case report

Prune belly syndrome (PBS) is a rare congenital disorder predominantly affecting males, making cases involving females, and particularly pregnant women, uncommon. A clinical manifestation of PBS is abdominal muscle deficiency, which may contribute to a prolonged second stage of labor (PSSL). To date, only four cases of labor in women with PBS have been reported in the literature: three gave birth by cesarean section (CS) and one by vacuum-assisted vaginal delivery. Whether spontaneous vaginal delivery is achievable in women with PBS and hypoplastic abdominal muscles, without the need for instrumental or operative assistance, has not yet been described in the literature. In this case report, we describe a successful spontaneous vaginal delivery in a woman with PBS affecting her abdominal muscles, who had a short interpregnancy interval and previously undergone an emergency CS due to PSSL. This case report suggests that spontaneous vaginal delivery may be feasible in cases with a mild phenotype of PBS. However, vaginal delivery may only be considered in highly selected cases and settings where immediate access to surgical intervention is available.