, Volume 18, Issue 3, pp 375–379 | Cite as

Suspected inguinal hernias in pregnancy—handle with care!

  • M. LechnerEmail author
  • R. Fortelny
  • D. Öfner
  • F. Mayer
Original Article



With a newly described diagnostic pathway, we aim to avoid unnecessary surgical exploration for suspected symptomatic groin hernias in pregnancy.


A consecutive series of eighteen pregnant women was referred to our department due to a gradual onset of inguinal swelling and groin ache. In a prospective clinical study, we evaluated these patients clinically and employed grey-scale and colour Doppler sonography (CDS) in all cases—following a newly described pathway. All patients were examined pre- and post-partum by two qualified surgeons. Median follow-up time was 11 months.


4/18 of the suspected hernias first occurred towards the end of the first, the majority (12/18) in the second, 2/18 in the last trimester and all were suspected after clinical examination only. Most women were referred by their gynaecologists. We found no hernias in any of the women but always noted large varicose veins along the round ligament during CDS. All women gave uncomplicated birth to single children, one by caesarean section. Complaints subsided spontaneously within roughly 2 weeks after delivery. No patient developed a groin hernia until the end of the follow-up period.


The diagnosis of an inguinal hernia with a first symptomatic onset during pregnancy may be wrong in most cases. Anamnesis and clinical examination must be backed by CDS and round ligament varicosity as an important differential diagnosis must always be considered. Our structured diagnostic pathway helps to easily make the correct diagnosis. Surgical exploration of the groin during pregnancy must be avoided.


Inguinal hernia Pregnancy Round ligament varicosity Diagnostic pathway 


Conflict of interest

All authors declare no conflicts of interests.


  1. 1.
    Andriessen M, Hartemink K, de Jong D (2009) Round ligament varicosities mimicking inguinal hernia during pregnancy. Ned Tijdschr Geneeskd 153:A169PubMedGoogle Scholar
  2. 2.
    Ijpma F, Boddeus K, De Haan H, van Geldere D (2008) Management of hernias in pregnancy. J Am Coll Surg 208:320CrossRefGoogle Scholar
  3. 3.
    Buch K, Tabrizian P, Divino C (2008) Management of hernias in pregnancy. J Am Coll Surg 207:539–542PubMedCrossRefGoogle Scholar
  4. 4.
    Guillem P, Bounoua F, Duval G (2001) Round ligament varicosities mimicking inguinal hernia: a diagnostic challenge during pregnancy. Acta Chir Belg 101(6):301–311Google Scholar
  5. 5.
    Ijpma F, Boddeus K, de Haan H, van Geldere D (2009) Bilateral round ligament varicosities mimicking inguinal hernia during pregnancy. Hernia 13:85–88PubMedCrossRefGoogle Scholar
  6. 6.
    Reisfield DR (1962) Varicosities in veins of the inguinal canal during pregnancy. J Med Soc NJ 59:24–26Google Scholar
  7. 7.
    McLaren CA, Brown PW (1983) Varicocoele in the female. J R Coll Surg Edinb 28:125PubMedGoogle Scholar
  8. 8.
    McKenna D, Carter J, Poder L, Gosnell J, Maa J, Pearl J, Goldstein R (2008) Round ligament varices: sonographic appearance in pregnancy. Ultrasound Obstet Gynecol 31:355–357PubMedCrossRefGoogle Scholar
  9. 9.
    Murphy G, Heffernan E, Gibney R (2007) Groin mass in pregnancy. Br J Radiol 80:588–589PubMedCrossRefGoogle Scholar
  10. 10.
    Uzun M, Akkan K, Coskun B (2010) Round ligament varicosities mimicking inguinal hernias in pregnancy: importance of color Doppler sonography. Diagn Interv Radiol 16:150–152PubMedGoogle Scholar
  11. 11.
    Buch K, Tabrizian P, Divino C (2008) Reply to: management of hernias in pregnancy. J Am Coll Surg 208:320–321CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  1. 1.Department of SurgeryParacelsus Medical University (PMU)SalzburgAustria
  2. 2.Department of General, Visceral and Oncological SurgeryWilhelminenspitalViennaAustria

Personalised recommendations