Caesarean section: a case report of critical attempt to abdominal wall

Introduction. Caesarean section (CS) represents the most widespread and performed procedure in obstetrics. It is an undisputed guaranty in life-threatening conditions, as a primary choice to decrease mortality and morbidity of women and new-borns. Case report. We describe an exceptional case of a pregnant woman, previously undergone to several surgical procedures because of a unique and complex abdominal and genito-urinary congenital abnormality, with an extended prosthetic abdominoplasty. In 2018 the patient experienced a spontaneous pregnancy, whose course was strictly controlled in our center by a specialized multidisciplinary team. Pregnancy, despite multiple problems, hesitated in an only slightly preterm birth, since the CS was planned at 36 weeks of gestation, in order to avoid possible complications both for the mother and the baby over the last weeks. The CS was mandatory because of the complex congenital abnormality of the patient. It was performed by a lateral paramedian abdominal incision, in order to avoid any transection of the abdominal mesh. Both the post-operative period and the follow-up were uneventful. Newborn was in good condition and completely breastfeed. Conclusions. The individualized technique used for CS demonstrate the importance to adapt the surgical technique even in a procedure whose approach is standardized all over the world.