Introduction
Prune-Belly Syndrome (PBS) is a rare condition with a notable male predominance. It is characterized by a spectrum of anomalies, which can vary in severity, including the classic triad: aplasia or hypoplasia of the abdominal musculature, dilations of the urinary tract, and bilateral cryptorchidism. Diagnosis typically requires a radiological and clinical approach, underscoring the significance of first-trimester ultrasound for early detection.

Objective
The aim of this study is to demonstrate that early suspicion of Prune-Belly Syndrome (PBS) during pregnancy facilitates the identification of associated anomalies and provides a more accurate prognosis.

Method
This case report presents a fetus diagnosed with Prune-Belly Syndrome in the first trimester, with confirmation through fetal pathology following medical termination of the pregnancy.

Case Report
A 36-year-old woman, gravida 2, para 0, with no significant medical or surgical history, presented for evaluation at our department after her first pregnancy, which ended at 20 weeks due to trisomy 18. Both pregnancies were from a non-consanguineous relationship.
Ultrasonography at 13 weeks gestation revealed a megacystis, prompting referral for further evaluation. Chorionic villus sampling confirmed a normal karyotype. A follow-up ultrasound at 16 weeks showed worsening of the megacystis, resulting in bilateral hydronephrosis and oligohydramnios.
Given the anticipated renal dysfunction, the parents chose to terminate the pregnancy.
Postmortem examination at 18 weeks revealed a male fetus with a dilated urinary tract, kidney dysplasia, and a defect in the abdominal wall musculature.

Conclusion
Although the pregnancy in this case was terminated at the request of the parents, this study underscores the importance of early ultrasound detection in diagnosing Prune-Belly Syndrome. Early diagnosis facilitates better management and informed decision-making regarding prognosis and potential outcomes.