Vaginal delivery after abdominal wall replacement by Marlex mesh

Abstract

A 33-year-old woman booked for the antenatal care at 12 weeks of pregnancy. The woman had a history of six operations performed on her anterior abdominal wall. The ® rst operation was at age 17 years to remove a desmoid tumour situated on the left anterior abdominal wall. This was followed by three recurrences, which necessitated wide excision. She also underwent two further operations to remove excessive scar tissue which led to a wide defect in her anterior abdominal wall requiring closure by prosthesis‐ Marlex mesh. The prosthesis covered all of her left abdominal wall. At the age of 24 years, she developed small bowel obstruction and at laparotomy, distal ileum was found to be adherent to the Marlex mesh and resection of 10 cm of the ileum was performed with end-to-end anastamosis. She was reviewed 4-weekly in the antenatal clinic and the pregnancy progressed uneventfully. At 35 weeks of pregnancy she reported decreased fetal movements. Ultrasound scan for fetal growth along with umbilical