Umbilical hernia in pregnancy
introduction
In medical terminology, the term umbilical hernia is a special form of hernia that can occur in both infancy and adulthood. While hernias generally occur in the groin or thigh area, the umbilical hernia occurs in the umbilical region.
Umbilical hernias differ from other hernias in terms of their causes, development, typical symptoms and treatment. For this reason, they must be viewed as an independent clinical picture in everyday clinical practice.
causes
The cause of the formation of an umbilical hernia is always a weak point in the abdominal wall, the development or enlargement of which is favored by increased abdominal pressure.
Umbilical hernias can be observed quite often, especially during pregnancy. Furthermore, many women also suffer from an umbilical hernia after pregnancy. In most cases, the excessive stretching of the abdominal wall and the resulting divergence of the abdominal muscles is the real reason for umbilical hernias during and after pregnancy. In this way, the abdominal wall becomes thinner and weaker. The individual muscle fibers are no longer so close to one another and weak points through which the intestinal sections can emerge arise.
An umbilical hernia that occurs during or after pregnancy is usually completely harmless and does not cause any discomfort to most women. If the umbilical hernia occurs before birth, the birth of the child is not hindered in any way. There is no increased risk for mother and child.
Symptoms
In the majority of cases, women with an umbilical hernia do not complain of pain during or after pregnancy.
However, should the affected patient experience pain or even noticeable discoloration in the area of the umbilical hernia, a doctor should be consulted immediately. A painful umbilical hernia with bluish discoloration is a serious indication of the presence of a so-called incarceration. This means that intestinal tissue has become jammed in the hernial orifice. As a result of this event, the intestinal sections inside the hernial sac can no longer be properly supplied with blood.
A painful umbilical hernia during or after pregnancy is therefore an emergency that must be treated immediately. If a suitable therapy is neglected, there is a risk of death of the intestinal sections located in the hernial sac. This can lead to serious complications such as blood poisoning (sepsis) and / or peritonitis (Peritonitis) to lead.
Other symptoms that should be treated with caution in the presence of an umbilical hernia during and after pregnancy are the occurrence of gushing vomiting and irregular bowel movements. Clamping off individual sections of the intestine can result in insufficient passage of the intestinal contents. Especially constipation (Constipation) are typically the result.
Read more on the topic: Typical symptoms of an umbilical hernia
Diagnosing an umbilical hernia in pregnancy
An umbilical hernia can be diagnosed during or after pregnancy by simply examining the umbilical region. In addition, an umbilical hernia can be felt quite easily.
Taking X-rays or the like is not necessary for this clinical picture and is also contraindicated because of the radiation exposure.
If an incarceration is suspected due to the symptoms, so-called Doppler sonography (ultrasound to visualize the blood flow) may be performed.
In very rare exceptional cases, an MRI can be considered. An MRI is possible during pregnancy in the second and last trimester. However, the indication for this examination should be strictly checked.
Read more on this topic at: MRI in pregnancy.
therapy
Even if there is an umbilical hernia during or after pregnancy, treatment can be carried out in different ways:
Umbilical hernia during pregnancy
- In women who do not complain of any symptoms, in most cases no therapy is used at all. An umbilical hernia that occurs during pregnancy often resolves on its own after the pressure in the abdominal space has decreased. This means that most umbilical hernias will simply go away after pregnancy without medical intervention.
- In the rare case that therapy has to be carried out during pregnancy due to pain, the procedure is as gentle as possible so as not to harm either the mother or the unborn child - this means that an invasive procedure is initially avoided and only to the extreme Emergency carried out.
- In both cases there is the option of having the umbilical hernia taped by experienced midwives or physiotherapists. Using kinesio tapes, certain adhesive techniques can be used to stabilize the abdominal wall muscles, which prevents the intestinal loops from coming out. However, this therapy option should first be clarified with the treating gynecologist!
You may also be interested in this topic: Abs workouts during pregnancy
Umbilical hernia after pregnancy
First of all, wait some time after the delivery. Due to the reduced pressure in the abdomen, many umbilical hernias recede spontaneously and do not require any therapy.
However, a symptom-free umbilical hernia, which either occurs after pregnancy or does not go away after birth, is always an indication for surgical reduction, which is usually only carried out after the child is born.
Theoretically, it is possible to push the hernial sac back into the abdomen manually through the hernial port and treat the umbilical hernia in this way.
However, this therapy option is difficult in everyday practice. On the one hand, the hernial sac can become trapped in the area of the hernial port during manual repositioning, thus provoking an incarceration. On the other hand, the cause of the umbilical hernia, namely the actual weak point in the abdominal wall, is not eliminated in this way. The umbilical hernia would appear again through the abdominal wall at the latest the next time you press or cough heavily. During pregnancy, even the pressure caused by the unborn child is enough to provoke a renewed hernia sac.
After pregnancy, you can choose between two therapy options:
- In the case of small defects in the abdominal wall (up to about 2 cm in diameter), the weak point can usually be repaired with a simple suture. With this method, the surgical access (skin incision) is kept so small that scarcely visible scars remain afterwards.
- If there are major weak points in the abdominal wall or if an umbilical hernia occurs repeatedly, the abdominal wall should be reinforced. Plastic nets or patches are usually used for this purpose. This material is very well tolerated by most patients and can remain in the body for life.
Read more on the topic: Umbilical hernia surgery
How can you prevent an umbilical hernia during pregnancy?
An umbilical hernia is favored by a weakness in the abdominal wall. So it is recommended for prevention
- to aim for a normal weight,
- not to lift heavy loads,
- to strengthen the abdominal muscles even before pregnancy through physical activity and specific exercises.
Do I have to have a caesarean section if I have an umbilical hernia?
An umbilical hernia during pregnancy does not necessarily mean that a caesarean section must be performed. The child can also be born naturally with an umbilical hernia.
Newer procedures combine a caesarean section with umbilical hernia treatment. The advantage is that only one procedure has to be performed. However, this procedure is not yet a standard in Germany.
However, the severity of the umbilical hernia and any risk factors must be assessed individually for each pregnant woman before the decision on the mode of delivery can be made. Therefore, only the attending gynecologist can give a well-founded recommendation.
forecast
After surgery to correct an umbilical hernia after pregnancy, the prognosis is usually very good.
If the suturing method is carried out correctly, the possibility of another umbilical hernia at the same point is almost impossible. Even if the umbilical hernia is provided with a plastic mesh or patch, the risk of recurrence is negligible.
Is It Dangerous to Get Pregnant with an Untreated Umbilical Hernia?
An umbilical hernia during pregnancy often resolves on its own. In addition, an umbilical hernia can develop independently of pregnancy. If it does not resolve, it will be decided individually how to proceed:
- In certain cases, specialists recommend not treating the umbilical hernia until family planning has been completed, as there is a high probability that it will return in the next pregnancy. The unborn child itself is not endangered by the umbilical hernia - the abdominal wall is loosened, the child cannot become trapped.
- Other specialists, on the other hand, advise waiting some time after the delivery and, if the umbilical hernia does not resolve, intervene surgically. According to the previous recommendation, this should happen some time after the delivery, but before the next pregnancy.
As mentioned above, the procedure for treating an umbilical hernia before pregnancy absolutely requires professional clarification and is decided individually. For this reason, you should definitely consult a gynecologist who will treat your individual case and, after a comprehensive examination, assess which solution is the more economical.
