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Hernia

, Volume 19, Issue 5, pp 689–696 | Cite as

Abdominal wall hernia and pregnancy: a systematic review

  • K. K. Jensen
  • N. A. Henriksen
  • L. N. Jorgensen
Review

Abstract

Purpose

There is no consensus as to the treatment strategy for abdominal wall hernias in fertile women. This study was undertaken to review the current literature on treatment of abdominal wall hernias in fertile women before or during pregnancy.

Methods

A literature search was undertaken in PubMed and Embase in combination with a cross-reference search of eligible papers.

Results

We included 31 papers of which 23 were case reports. In fertile women undergoing sutured or mesh repair, pain was described in a few patients during the last trimester of a subsequent pregnancy. Emergency surgery of incarcerated hernias in pregnant women, as well as combined hernia repair and cesarean section appears as safe procedures. No major complications were reported following hernia repair before or during pregnancy. The combined procedure of elective cesarean section and abdominal wall hernia repair was reported in 102 patients without major complications.

Conclusions

The literature on abdominal wall hernia and pregnancy is sparse. Abdominal wall hernia repair with suture or mesh may cause pain in the last trimester of a subsequent pregnancy. Hernia repair in conjunction with cesarean section appear as the optimal treatment of a pregnant patient with a symptomatic abdominal wall hernia.

Keywords

Abdominal wall hernia Hernia Pregnancy Mesh Ventral hernia 

Notes

Conflict of interest

KJ, NH and LJ declare no conflict of interest.

References

  1. 1.
    Choi JJ, Palaniappa NC, Dallas KB, Rudich TB, Colon MJ, Divino CM (2012) Use of mesh during ventral hernia repair in clean-contaminated and contaminated cases: outcomes of 33,832 cases. Ann Surg 255:176–180CrossRefPubMedGoogle Scholar
  2. 2.
    den Hartog D, Dur AH, Tuinebreijer WE, Kreis RW (2008) Open surgical procedures for incisional hernias. Cochrane Database Syst Rev: CD006438Google Scholar
  3. 3.
    Junge K, Klinge U, Prescher A, Giboni P, Niewiera M, Schumpelick V (2001) Elasticity of the anterior abdominal wall and impact for reparation of incisional hernias using mesh implants. Hernia 5:113–118CrossRefPubMedGoogle Scholar
  4. 4.
    Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6:e1000097CrossRefGoogle Scholar
  5. 5.
    Aaen V, Cowan L, Sakala EP, Small ML (1993) Prolonged parenteral meperidine analgesia during pregnancy for pain from an abdominal wall mesh graft. Obstet Gynecol 82:721–722PubMedGoogle Scholar
  6. 6.
    Buch KE, Tabrizian P, Divino CM (2008) Management of hernias in pregnancy. J Am Coll Surg 207:539–542CrossRefPubMedGoogle Scholar
  7. 7.
    Schoenmaeckers E, Stirler V, Raymakers J, Rakic S (2012) Pregnancy following laparoscopic mesh repair of ventral abdominal wall hernia. JSLS 16:85–88PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Abrahamson J, Gorman J (2000) Pregnancy and ventral hernia repair. Hernia 4:187–191CrossRefGoogle Scholar
  9. 9.
    Ehigiegba AE, Selo-Ojeme DO (1999) Myomectomy in pregnancy: incarcerated pedunculated fibroid in an umbilical hernia sac. Int J Clin Pract 53:80PubMedGoogle Scholar
  10. 10.
    Uludag M, Yetkin G, Demirel M, Citgez B, Isgor A (2006) Incarceration of umbilical hernia during pregnancy due to a sessile fibroid. Hernia 10:357–359CrossRefPubMedGoogle Scholar
  11. 11.
    Seims AD, Lube MW (2009) Incarceration of a sessile uterine fibroid in an umbilical hernia during pregnancy. Hernia 13:309–311CrossRefPubMedGoogle Scholar
  12. 12.
    Wong C (2005) A uterine fibroid presenting as an incarcerated umbilical hernia during pregnancy. Hernia 9:298–299CrossRefPubMedGoogle Scholar
  13. 13.
    Perry Z, Netz U, Yitzhak A, Mizrahi S (2011) Pros and cons in the approach to an incarcerated umbilical hernia in the pregnant woman. Am Surg 77:E43–E44PubMedGoogle Scholar
  14. 14.
    Ahmed A, Stephen G, Ukwenya Y (2011) Spontaneous rupture of umbilical hernia in pregnancy: a case report. Oman Med J 26:285–287PubMedCentralCrossRefPubMedGoogle Scholar
  15. 15.
    Zalel Y, Shalev E, Romano S, Ben-Ami M, Dan U, Weiner E (1992) Incarcerated Spigelian hernia in pregnancy: an ultrasonic diagnosis. J Clin Ultrasound 20:146–148CrossRefPubMedGoogle Scholar
  16. 16.
    Udare AS, Bhalekar PS, Mondel PK (2013) Sonographic diagnosis of incarcerated Spigelian hernia during pregnancy. Int J Gynaecol Obstet 120:284–285CrossRefPubMedGoogle Scholar
  17. 17.
    Limjoco UR, Grubbs JM, Thomas MD (1998) Richter’ hernia with bowel perforation. Am Fam Physician 58(352):354Google Scholar
  18. 18.
    Wai PY, Ruby JA, Davis KA, Roberts AC, Roberts KE (2009) Laparoscopic ventral hernia repair during pregnancy. Hernia 13:559–563CrossRefPubMedGoogle Scholar
  19. 19.
    Martin LF, Barry MG, Peeno DO, Fry DE (1985) Abdominal wall repair with polypropylene mesh in pregnancy. Obstet Gynecol 66:141–143PubMedGoogle Scholar
  20. 20.
    Deka D, Banerjee N, Takkar D (2000) Incarcerated pregnant uterus in an incisional hernia. Int J Gynaecol Obstet 70:377–379CrossRefPubMedGoogle Scholar
  21. 21.
    Altchek A, Rudick J (1987) Preperitoneal herniorrhaphy: adjunct to cesarean section. Obstet Gynecol 70:470–471PubMedGoogle Scholar
  22. 22.
    Ochsenbein-Kolble N, Demartines N, Ochsenbein-Imhof N, Zimmermann R (2004) Cesarean section and simultaneous hernia repair. Arch Surg 139:893–895CrossRefPubMedGoogle Scholar
  23. 23.
    Gabriele R, Conte M, Izzo L, Basso L (2010) Cesarean section and hernia repair: simultaneous approach. J Obstet Gynaecol Res 36:944–949CrossRefPubMedGoogle Scholar
  24. 24.
    Ghnnam WM, Helal AS, Fawzy M, Ragab A, Shalaby H, Elrefaay E (2009) Paraumbilical hernia repair during cesarean delivery. Ann Saudi Med 29:115–118PubMedCentralCrossRefPubMedGoogle Scholar
  25. 25.
    Steinemann DC, Limani P, Ochsenbein N, Krahenmann F, Clavien PA, Zimmermann R, Hahnloser D (2013) Suture repair of umbilical hernia during caesarean section: a case–control study. Hernia 17:521–526CrossRefPubMedGoogle Scholar
  26. 26.
    Saha PK, Rohilla M, Prasad GR, Dhaliwal LK, Gupta I (2006) Herniation of gravid uterus: report of 2 cases and review of literature. MedGenMed 8:14PubMedCentralPubMedGoogle Scholar
  27. 27.
    Palazzo F, Ragazzi S, Ferrara D, Piazza D (2010) Herniated gravid uterus through an incisional hernia treated with the component separation technique. Hernia 14:101–104CrossRefPubMedGoogle Scholar
  28. 28.
    Mbuagbaw LC, Morfaw FL (2012) Gravid uterus in an umbilical hernia. Case Rep Obstet Gynecol 2012:439489PubMedCentralPubMedGoogle Scholar
  29. 29.
    Punguyire D, Iserson KV, Apanga S (2011) Full-term pregnancy in umbilical hernia. Pan Afr Med J 8:6PubMedCentralPubMedGoogle Scholar
  30. 30.
    Sahu L, Bupathy A (2006) Evisceration of pregnant uterus through the incisional hernia site. J Obstet Gynaecol Res 32:338–340CrossRefPubMedGoogle Scholar
  31. 31.
    Young BC, Fugelso D, Takoudes T (2009) Incisional hernia with bowel incarceration and obstruction at 34 weeks gestational age. Arch Gynecol Obstet 279:905–907CrossRefPubMedGoogle Scholar
  32. 32.
    Banerjee N, Deka D, Sinha A, Prasrad R, Takkar D (2001) Gravid uterus in an incisional hernia. J Obstet Gynaecol Res 27:77–79CrossRefPubMedGoogle Scholar
  33. 33.
    Agrawal S, Madan M, Kumari R, Gaikwad H, Raghunandan C, Leekha N, Ghuliani M (2010) Gravid uterus as a content of anterior abdominal wall incisional hernia. J Obstet Gynaecol 30:518–519CrossRefPubMedGoogle Scholar
  34. 34.
    Rao RS, Shankaregowda HS (2006) A case of herniated gravid uterus through a laparotomy scar. Indian J Med Sci 60:154–157CrossRefPubMedGoogle Scholar
  35. 35.
    Malhotra M, Sharma JB, Wadhwa L, Arora R (2003) Successful pregnancy outcome after cesarean section in a case of gravid uterus growing in an incisional hernia of the anterior abdominal wall. Indian J Med Sci 57:501–503PubMedGoogle Scholar
  36. 36.
    Kim WB, Kim J, Boo YJ, Park SH, Song TJ, Suh SO (2009) Successful vaginal delivery following laparoscopic abdominal wall reconstruction in an adult survivor of an omphalocele without prior surgical repair: report of a case. Hernia 13:431–434CrossRefPubMedGoogle Scholar
  37. 37.
    Christoffersen MW, Helgstrand F, Rosenberg J, Kehlet H, Bisgaard T (2013) Lower reoperation rate for recurrence after mesh versus sutured elective repair in small umbilical and epigastric hernias. A nationwide register study. World J Surg 37:2548–2552CrossRefPubMedGoogle Scholar
  38. 38.
    Simchen E, Wax Y, Galai N, Israeli A (1992) Differential effect of risk factors on early and late wound infections in patients undergoing herniorrhaphies. Ann Epidemiol 2:263–272CrossRefPubMedGoogle Scholar
  39. 39.
    Liem MS, van der Graaf Y, Zwart RC, Geurts I, van Vroonhoven TJ (1997) Risk factors for inguinal hernia in women: a case–control study. The Coala Trial Group. Am J Epidemiol 146:721–726CrossRefPubMedGoogle Scholar
  40. 40.
    Ruhl CE, Everhart JE (2007) Risk factors for inguinal hernia among adults in the US population. Am J Epidemiol 165:1154–1161CrossRefPubMedGoogle Scholar
  41. 41.
    Rosemar A, Angeras U, Rosengren A (2008) Body mass index and groin hernia: a 34-year follow-up study in Swedish men. Ann Surg 247:1064–1068CrossRefPubMedGoogle Scholar
  42. 42.
    Debrah SA, Okpala AM (2013) Epigastric hernia in pregnancy: a management plan based on a systematic review of literature and a case history. Indian J Surg 75:212–213PubMedCentralCrossRefPubMedGoogle Scholar
  43. 43.
    Mayer IE, Hussain H (1998) Abdominal pain during pregnancy. Gastroenterol Clin North Am 27:1–36CrossRefPubMedGoogle Scholar
  44. 44.
    Vikanes AV, Stoer NC, Magnus P, Grjibovski AM (2013) Hyperemesis gravidarum and pregnancy outcomes in the Norwegian mother and child cohort—a cohort study. BMC Pregnancy Childbirth 13:169PubMedCentralCrossRefPubMedGoogle Scholar
  45. 45.
    Shetty MK (2010) Abdominal computed tomography during pregnancy: a review of indications and fetal radiation exposure issues. Semin Ultrasound CT MR 31:3–7CrossRefPubMedGoogle Scholar
  46. 46.
    IJpma FF, Boddeus KM, de Haan HH, van Geldere D (2009) Bilateral round ligament varicosities mimicking inguinal hernia during pregnancy. Hernia 13:85–88CrossRefPubMedGoogle Scholar
  47. 47.
    Lechner M, Fortelny R, Ofner D, Mayer F (2014) Suspected inguinal hernias in pregnancy—handle with care! Hernia 18:375–379CrossRefPubMedGoogle Scholar
  48. 48.
    Johnson A, Young D, Reilly J (2006) Caesarean section surgical site infection surveillance. J Hosp Infect 64:30–35CrossRefPubMedGoogle Scholar
  49. 49.
    Aabakke AJ, Krebs L, Ladelund S, Secher NJ (2014) Incidence of incisional hernia after cesarean delivery: a register-based cohort study. PLoS One 9:e108829PubMedCentralCrossRefPubMedGoogle Scholar
  50. 50.
    Mikkelsen T, Bay-Nielsen M, Kehlet H (2002) Risk of femoral hernia after inguinal herniorrhaphy. Br J Surg 89:486–488CrossRefPubMedGoogle Scholar
  51. 51.
    Mazze RI, Kallen B (1991) Appendectomy during pregnancy: a Swedish registry study of 778 cases. Obstet Gynecol 77:835–840PubMedGoogle Scholar
  52. 52.
    Sadot E, Telem DA, Arora M, Butala P, Nguyen SQ, Divino CM (2010) Laparoscopy: a safe approach to appendicitis during pregnancy. Surg Endosc 24:383–389CrossRefPubMedGoogle Scholar
  53. 53.
    Affleck DG, Handrahan DL, Egger MJ, Price RR (1999) The laparoscopic management of appendicitis and cholelithiasis during pregnancy. Am J Surg 178:523–529CrossRefPubMedGoogle Scholar
  54. 54.
    Visser BC, Glasgow RE, Mulvihill KK, Mulvihill SJ (2001) Safety and timing of nonobstetric abdominal surgery in pregnancy. Dig Surg 18:409–417CrossRefPubMedGoogle Scholar
  55. 55.
    Kuczkowski KM (2006) The safety of anaesthetics in pregnant women. Expert Opin Drug Saf 5:251–264CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag France 2015

Authors and Affiliations

  • K. K. Jensen
    • 1
  • N. A. Henriksen
    • 1
  • L. N. Jorgensen
    • 1
  1. 1.Digestive Disease Center, Bispebjerg HospitalUniversity of CopenhagenCopenhagen NVDenmark

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