Labial Adhesion Surgery Prior to Vaginal Delivery in a Patient With Vulvar Lichen Planus Causing Labial Adhesion: A Case Report

Lichen planus is an inflammatory disease that affects the skin and mucous membranes, and although rare, it can manifest in the vulvar region. Vulvar lichen planus can occur in women of reproductive age and may cause vulvar adhesion, potentially complicating examinations and delivery during pregnancy. We report a case in which a pregnant woman with vulvar adhesion due to vulvar lichen planus successfully delivered vaginally following labiaplasty. The patient, a 31-year-old primigravida, was initially diagnosed with vulvar lichen planus approximately three years before her first visit to our hospital. Two months prior to her visit, she conceived through artificial insemination after letrozole administration. At her initial visit, her labial adhesion left only a small opening at the vaginal introitus, barely allowing the insertion of the little finger. At 12 weeks and five days of gestation, a labiaplasty was performed under spinal anesthesia. Postoperative treatment included topical steroids and tacrolimus ointment, leading to a full-term vaginal delivery. The estimated blood loss during delivery was 470 mL. In cases where vaginal delivery may be challenging due to conditions such as labial adhesion, performing labiaplasty during pregnancy may facilitate a normal birth.