Successful pregnancy after abdominal wall reconstruction surgery

Abstract

Abdominal wall reconstruction in women of childbearing age represents a complex and rarely reported clinical challenge. Various reconstructive techniques, including mesh repair and autologous tissue flaps, have been described, but no consensus has been established regarding optimal management. We present the fifth documented case of successful pregnancy and delivery following autologous abdominal wall reconstruction. A 35-year-old woman with a desmoid tumor underwent surgical removal, resulting in an 11 × 13 cm abdominal wall defect. Reconstruction was performed using a pedicled fascia lata flap based on perforators from the lateral circumflex femoral artery. The patient was advised to defer pregnancy for 1 year postoperatively. Twenty-eight months after reconstruction, she underwent cesarean delivery through a vertical incision to avoid the reconstructed area. No complications, such as abdominal wall hernia or bulging, were observed during the perinatal period or at 3 years and 2 months postoperatively. This case demonstrated that large abdominal wall defects can be safely reconstructed with vascularized tissue, yielding favorable perinatal outcomes during subsequent pregnancy. Our experience underscores the potential of vascularized fascial flaps as a durable and physiologically integrated option for abdominal wall reconstruction in women who desire future pregnancies. Further case accumulation is warranted to establish evidence-based guidelines for surgical and perinatal management.