Umbilical Hernia Repair and Pregnancy: Before, during, after…

Abstract

Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable. If the hernia is not complicated, but symptomatic an elective repair should be proposed. When the patient has a small and asymptomatic hernia it may be better to postpone the repair until she gives birth. If the hernia is repaired by suture alone, a high risk of recurrence exists during pregnancy. Umbilical hernia repair during pregnancy can be performed with minimal morbidity to the mother and baby. Second trimester is a proper timing for surgery. Asymptomatic hernias can be repaired, following childbirth or at the time of cesarean section (C-section). Elective repair after childbirth is possible as early as postpartum of eighth week. A 1-year interval can give the patient a very smooth convalescence, including hormonal stabilization and return to normal body weight. Moreover, surgery can be postponed for a longer time even after another pregnancy, if the patients would like to have more children. Diastasis recti are very frequent in pregnancy. It may persist in postpartum period. A high recurrence risk is expected in patients with rectus diastasis. This risk is especially high after suture repairs. Mesh repairs should be considered in this situation.

An atypical presentation of a mesenteric Meckel’s diverticulum in a 7-year-old warmblood mare: case report

“…Surgical intervention is straightforward for symptomatic diverticula, however a prophylactic surgical intervention for asymptomatic incidental diverticula is debatable [ 9 , 12 , 26 ]. Based on the risk factors, most surgeons advise a resection of the diverticulum or mesodiverticular band if found at laparotomy, as it may predispose for episodes of colic [ 11 , 16 , 17 , 27 ]. In human medicine several surgical options have been described for cases of Meckel’s diverticula [ 27 ].…”

“…Based on the risk factors, most surgeons advise a resection of the diverticulum or mesodiverticular band if found at laparotomy, as it may predispose for episodes of colic [ 11 , 16 , 17 , 27 ]. In human medicine several surgical options have been described for cases of Meckel’s diverticula [ 27 ]. Based on the encountered anatomy, its relation to the colic signs and if applicable the viability of the strangulated part, a diverticulectomy, a wedge resection or a segmental resection is performed [ 25 , 26 ].…”

Simultaneous Repair of Para-Umbilical Hernia during Cesarean Section (CS): A Novel Approach

“…Repairing hernia during C-section is an approach of surgical management of such lesion. But, performing both surgeries simultaneously neither were nor recommended until the 2000s [1]. As paraumbilical hernias are liable to complications e.g.…”

“…Surgeons who refused such procedure described hazards of repair during CS e.g. changes in Muscles and Fascial Structures during Pregnancy, the rectus abdominis muscle is changed during pregnancy with a significant increase in muscle length, separation, and changes in angles of insertions as the pregnancy progressed and the ability to stabilize the pelvis is decreased [1].…”

“…Pregnancy may lead to occurrence of umbilical hernia, or allow a preexisting one to be more apparent, due to increasing intra-abdominal pressure progressively. Para-umbilical hernia may be diagnosed during 1 st , 2 nd , or 3 rd pregnancies and its presenting symptoms most probably present in the 2 nd trimester in most patients [1]. And surgical management of para-umbilical hernias is considered the commonest surgical procedures.…”