Ventral hernia and pregnancy: A systematic review

Oma, Erling; Henriksen, Nadia A; Jensen, Kristian K.

doi:10.1016/j.amjsurg.2018.04.016

Cited by 18 publications

(15 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Physiological changes of the abdominal wall during pregnancy may increase the risk of recurrence, which is why optimal timing of the repair is important for women of childbearing age. The current recommendations are based on four large cohort studies and two systematic reviews.…”

Section: Resultsmentioning

confidence: 99%

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Rare locations of hernias, as well as primary ventral hernias under certain circumstances (cirrhosis, dialysis, rectus diastasis, subsequent pregnancy), might be technically challenging. The aim was to identify situations where the treatment strategy might deviate from routine management. Methods The guideline group consisted of surgeons from the European and Americas Hernia Societies. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used in formulating the recommendations. The Scottish Intercollegiate Guidelines Network (SIGN) critical appraisal checklists were used to evaluate the quality of full‐text papers. A systematic literature search was performed on 1 May 2018 and updated 1 February 2019. The Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was followed. Results Literature was limited in quantity and quality. A majority of the recommendations were graded as weak, based on low quality of evidence. In patients with cirrhosis or on dialysis, a preperitoneal mesh repair is suggested. Subsequent pregnancy is a risk factor for recurrence. Repair should be postponed until after the last pregnancy. For patients with a concomitant rectus diastasis or those with a Spigelian or lumbar hernia, no recommendation could be made for treatment strategy owing to lack of evidence. Conclusion This is the first European and American guideline on the treatment of umbilical and epigastric hernias in patients with special conditions, including Spigelian and lumbar hernias. All recommendations were weak owing to a lack of evidence. Further studies are needed on patients with rectus diastasis, Spigelian and lumbar hernias.

show abstract

Section: Resultsmentioning

confidence: 99%

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…If the hernia is large and symptomatic, it may be better to postpone the repair to the second trimester, or until after delivery if the hernia remains stable. Hernia repair combined with a cesarean section (CS) involves a multifactorial decision-making process that varies from case to case, and this combination is not recommended routinely [9,10]; however, one study has revealed that this combination is an accepted practice [13]. Regarding groin hernia during pregnancy, it does not require routine repair [14].…”

Section: Determining the Best Time For Elective Surgerymentioning

confidence: 99%

“…Nouh et al conducted a systematic review study to evaluate the recurrence rate of ventral hernia in fertile women who underwent repair before pregnancy [12]. Oma et al conducted another study with the same objective [10]. Both studies shared similarities in goal and patient groups but differed in terms of patient numbers and quality checks.…”

Section: Determining the Best Time For Elective Surgerymentioning

confidence: 99%

“…All these factors make the diagnosis of hernias challenging. The decision regarding an appropriate treatment option is also controversial due to the lack of high-quality clinical trials [9][10][11], and many questions remain unsolved: is the best time to repair hernia before, during, or after pregnancy? Is the laparoscopic approach better than an open approach?…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

How to Treat Hernias in Pregnant Women?

Danawar

Mekaiel

Raut

et al. 2020

Cureus

View full text Add to dashboard Cite

A hernia is a common surgical problem. Although hernias during pregnancy are uncommon, they can be challenging for both the surgeon and the patient if present. To date, there is no consensus in the medical community regarding the elective repair of hernias in pregnant women. The debate mainly concerns three areas: the timing, the approach, and the surgical technique. This study aims to offer a clear pathway in this field based on the best available data. In this study, we collected reviews written in English and published in PubMed from 2010 to 2020 (the exception being three articles that were published before 2010, which we retained since they contained relevant information). We used regular and Medical Subject Headings (MeSH) keywords. Two of the authors screened the collected studies to select the best articles that would fit our inclusion criteria for the review. The articles considered for this review can be classified into retrospective studies, case reports, and reviews. No randomized controlled trials were found.

show abstract

“…Consequently, incisional hernia repair is a common procedure with about 350,000 repairs performed annually in the United States (2). Approximately every tenth patient undergoing incisional hernia repair is a woman of childbearing age (3). However, there is only sparse evidence on the risk of recurrence and chronic pain in women with an incisional hernia repair and a subsequent pregnancy (3).…”

Section: Introductionmentioning

confidence: 99%

Incisional hernia repair in women of childbearing age: A nationwide propensity-score matched study

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background & Aims: Although incisional hernia repair in women of childbearing age is not rare, hernia disease in this group of patients is sparsely documented. The aim of this study was to examine long-term clinical results after incisional hernia repair in women of childbearing age. Material and methods: This nationwide cohort study examined incisional hernia repair from 2007 to 2013 in women of childbearing age, registered prospectively in the Danish Ventral Hernia Database. All women with a subsequent pregnancy were included, and a 1:3 propensity-score matched group of women with an incisional hernia repair without a subsequent pregnancy. A prospective follow-up was conducted, including a validated questionnaire. The primary outcome was recurrence, and the secondary outcome was chronic pain from the operated site. Results: In total, 124 (70.5%) women responded, 47 and 77 women with and without a subsequent pregnancy, respectively. The 5-year cumulative incidence of recurrence was 41.0% (95% confidence interval 32.0%–49.9%). After adjustment for potential confounders, subsequent pregnancy was independently associated with recurrence (hazard ratio 1.83, 95% confidence interval 1.02–3.29, p = 0.044). Twenty-six (21.0%) women reported chronic pain (moderate, n = 21; severe, n = 5) with no difference between women with and without a subsequent pregnancy. Hernia recurrence, higher body mass index, and smoking were associated with chronic pain. Conclusion: Pregnancy following incisional hernia repair was associated with an increased risk of recurrence, but not with chronic pain.

show abstract

Ventral hernia and pregnancy: A systematic review

Cited by 18 publications

References 26 publications

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

EHS and AHS guidelines for treatment of primary ventral hernias in rare locations or special circumstances

How to Treat Hernias in Pregnant Women?

Incisional hernia repair in women of childbearing age: A nationwide propensity-score matched study

Contact Info

Product

Resources

About