Inguinal hernia during pregnancy: causes, symptoms, treatment. What you need to know about inguinal hernia during pregnancy? How to prevent pathology? Caesarean section for inguinal hernia

A woman during the bearing of a baby experiences serious stress, so various problems often arise in her body. For example, during pregnancy, an inguinal hernia may appear, which can lead to serious consequences. Usually this surgical pathology is typical for males, but sometimes it also manifests itself at a difficult moment for a woman when she is preparing to become a mother.

An inguinal hernia is a protrusion of organs located in the abdominal region into the inguinal canal. It occurs due to weakness of the abdominal muscles. The hernial sac may contain a section of the intestine or omentum, and sometimes part of the ovaries, uterus and bladder.

The inguinal canal is a slit-like opening, which consists of four walls. It is necessary for the round ligament of the uterus to pass through it. If the abdominals are weak, individual segments may protrude into this opening. internal organs sometimes entire organs. Even in a healthy body, this place is considered weak, and it is quite difficult to avoid health problems during the period of bearing a baby.

The appearance of pathology is associated with an increase in pressure in the abdominal region. The longer the gestation period, the higher it is. Causes of an inguinal hernia can be:

• chronic constipation;
• excess body weight;
• increased physical activity;
• stretching of the abdominal muscles, which is caused by the growth of the fetus;
• low tone of the abdominal muscles;
• chronic cough.

Whether to remove the pathology, the doctor decides, guided by the condition of the woman and her child. In most cases, they try to avoid surgical intervention, because any operation during pregnancy is accompanied by various difficulties and complications.

Symptoms of an inguinal hernia and its consequences

Pathology is easy to recognize. When a woman assumes a vertical position, a specific protrusion is noticeable in the inguinal region. When straining, it increases. At the same time, pain is present. They become pronounced during walking, lifting weights, defecation. If the pregnant woman is in a horizontal position, the pain usually goes away.

The diagnosis is made directly by the doctor. To do this, he visually examines the patient, performs palpation, and, if necessary, prescribes an ultrasound scan.

For a woman carrying a baby, an inguinal hernia is dangerous because it does not go away by itself. On the contrary, surgical pathology can progress rapidly. In this case, there is a high probability that infringement may occur. It leads to impaired blood circulation in the organs that are located in the hernial sac. If medical care is not provided on time, tissue necrosis and peritonitis will occur. They can lead to the death of the mother and her unborn child.

A number of symptoms are characteristic of infringement:

1. hardness of the hernia during its palpation;
2. fever and chills;
3. nausea and vomiting;
4. severe pain in the groin.

In this case, the pregnant woman is obliged to urgently contact a medical institution in order to avoid undesirable consequences for herself and the fetus.

Methods for the treatment of inguinal hernia

There is only one way to get rid of pathology - surgery. There is no other way out. However, it is postponed as a last resort, when emergency circumstances arise. If an infringement occurs, then the patient is immediately hospitalized, the most appropriate tactic of surgical intervention is chosen, and the operation is performed.

To avoid the progression of an inguinal hernia, a pregnant woman is recommended:

• wear a special support bandage;
• follow a diet that will not provoke frequent constipation and obesity;
• use therapeutic exercises and massage;
• give up excessive physical activity.

When the pathology has not reached a large size, a woman may well give birth naturally. The expectant mother will need to wear a support bandage, which reduces the load on the abdominal muscles. In addition, the midwife should support the area of ​​the hernia with the palm of her hand so that the bulge does not increase.

If the pathology is pronounced, and the abdominal muscles are too weak, a caesarean section is prescribed. This method is chosen because during natural childbirth there is an increased risk of strangulation.

Therefore, every pregnant woman should take appropriate preventive measures to reduce the chance of an inguinal hernia. If it has appeared, then you should carefully monitor your condition in order to promptly seek medical help if necessary. With untimely medical intervention, a fatal outcome can occur.

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This pathology is quite common among ordinary patients, and the inguinal one is the leader among all hernias. It is more characteristic of men (96%). But it is the inguinal hernia that occurs more often in women when carrying a baby. So, let's learn about it in detail.

Features and causes of the problem

The approach to this surgical pathology during pregnancy depends on many factors. On an individual basis, the doctor decides whether to operate on a hernia. This takes into account the condition of the woman and the peculiarities of the course of pregnancy. But most of the time they don't. Operations are carried out only in emergency cases when there is infringement.

What is this type of hernia? The inguinal canal is a gap-like space between the rectus abdominis muscles. It has always been considered a weak point in the body. The spermatic cord passes through the inguinal canal in the stronger sex. But in women - a round ligament of the uterus. Therefore, a hernia in the groin is nothing more than the exit of the abdominal organs through the inguinal canal. As practice shows, the hernial sac often contains part of the omentum or an intestinal loop.

Inguinal hernia is congenital and acquired. The main reason for its occurrence is increased intra-abdominal pressure. Recall that in expectant mothers with an increase in the uterus and the growth of the fetus, it always increases. This is the reason for the frequency of surgical pathology among pregnant women. In addition to the main reason, frequent constipation can provoke the appearance of an inguinal hernia during pregnancy. They often occur in expectant mothers. Heavy lifting, chronic, heavy physical exertion, weakness of the abdominal muscles can also contribute to the occurrence of this surgical pathology in pregnant women. All of them, combined with the pressure of the growing uterus on the groin and lower abdominal region, provoke the occurrence of an inguinal hernia in the second half of pregnancy.

Signs of surgical pathology

What does the clinical picture of a hernia in the groin look like? Its signs during the period of bearing a baby almost do not differ from the clinic of the disease in ordinary women. The main symptom is a protrusion in the groin area. It has an oval shape. The consistency of the pathology is soft-elastic, painless on palpation. Most expectant mothers state a feeling of discomfort in the protrusion zone. It is directly proportional to the gestational age. The protrusion appears in an upright position, more often after excessive and prolonged exertion. It disappears at rest and in a lying position. In rare cases, women note that the pain radiates to the lumbar region and sacrum. During pregnancy, the hernia grows, it increases along with the period of bearing the baby. The larger its size, the more inconvenience while walking, with little physical exertion, the expectant mother feels.

And also an inguinal hernia is accompanied by difficulty urinating, rumbling in the abdomen,.

Inguinal hernia and delivery

How a woman with this surgical pathology will give birth depends largely on the size of the protrusion and the presence of other pregnancy complications. Ordinary childbirth is possible only when the protrusion is small, there is a special supporting bandage. Then, in the process of delivery, in attempts, the obstetrician-gynecologist holds the hernia with his hand to avoid its infringement.

A caesarean section is indicated for those pregnant women who have a large inguinal hernia, there are other comorbidities, for example, an incorrect position of the fetus, anomalies in labor, or a complicated pregnancy. As practice shows, after the baby is born in newly-made mothers, the inguinal hernia disappears without a trace for some time.

All pregnant women with such a surgical pathology are recommended to wear a special bandage until the end of the term. They are strictly forbidden to lift weights. And exercise is taboo for them. This category of women needs to perform special exercises, the purpose of which is to strengthen the muscles of the abdominal wall. It is recommended for pregnant women and special compliance.

Speaking of inguinal hernia, it is generally accepted that men are more susceptible to this disease than women (photo). However, inguinal hernia during pregnancy is also quite common. It should be noted that the risk of this pathology in pregnant women increases significantly due to significantly increased intra-abdominal pressure.
For the same reasons, a hernia may occur after childbirth. But its formation occurs in the course of labor activity.

Etiology and pathogenesis of inguinal hernia during pregnancy

During pregnancy, during the growth of the embryo in the uterine cavity, its steady increase in size occurs. Inside the uterus, in addition to the developing embryo and subsequently the fetus, there are surrounding tissues, such as the fetal bladder, fetal umbilical cord, placenta. Additionally, in the cavity of the fetal bladder there is a certain amount amniotic fluid. Hernia and pregnancy become for some time the main cause of concern for the expectant mother.

The photo shows an inguinal hernia in a pregnant woman

With the development of pregnancy, the size of the fetus and all of the listed surrounding tissues increase. In proportion to this, the size and weight of the uterus increases, which already leaves the pelvic cavity and is located in the abdominal cavity. Now, the intra-abdominal pressure and, accordingly, the pressure on the abdominal muscles increases several times. With primary or secondary weakness of the abdominal muscles, the loops of the small intestine, mesentery, round uterine ligament are “squeezed out” through the inguinal ring into the subcutaneous tissue of the outer abdominal wall. This is how a hernial protrusion is formed in women during pregnancy. Especially often there is a fallout when multiple pregnancy among women.

Additional prerequisites that contribute to the formation of this pathology in pregnant women and women in labor are thinning and significant weakening of the rectus and oblique muscles of the abdomen, which make up the muscular corset due to their stretching. Constipation and other intestinal motility disorders also increase the risk of its formation. A factor such as lifting weights further increases the risk of hernia prolapse.

The main clinical symptoms of a hernia in pregnant women

Often, the first symptoms of a hernial protrusion are frequent urination, difficulty urinating, constipation and flatulence, as well as more or less acute difficulty walking. Sometimes these initial manifestations are left without due attention, since during pregnancy these factors appear without the presence of concomitant pathology.

Unlike the usual signs of a hernia, during pregnancy, it can cause significant inconvenience to a woman. Moreover, the longer the gestational age and the size of the hernial protrusion, the more discomfort the woman experiences. This is due to increasing intra-abdominal pressure from the second trimester of pregnancy until delivery. The hernia is most noticeable in the standing position and may not be expressed at all in the prone position.

In general, the resulting protrusion in the groin area is characterized by painlessness on palpation, softness and the ability to reduce the contents of the hernial sac in the supine position for a short period of time. Most of the symptoms during pregnancy, especially on early dates, the same as in the case of a hernia in non-pregnant women.

More problems arise in the case of a complicated course of the disease, with infringement of the hernia. Since with a hernia, the management of a pregnant woman is carried out taking into account the existing pathology, they often resort to the advisory assistance of surgical specialists. With a strangulated hernia in pregnant women, they are hospitalized in the prenatal department of the pathology of pregnant women.

Management of pregnant women, childbirth and preventive measures for hernia in pregnant women
In obstetric and gynecological patronage of women with an existing hernia, all medical measures should be aimed at preventing deterioration of the condition and even greater prolapse of internal organs into the hernial sac. So, it is not recommended to perform a set of exercises to prepare for childbirth with a hernia in pregnant women, because this type of exercise is aimed at strengthening the muscles of the anterior abdominal wall.

Due to the specifics of such exercises, intra-abdominal pressure increases. As a consequence, an infringement of an existing hernia or the debut of a similar pathology is possible. The consequences of this have been described in this article above. If a pregnant woman has a hernia, then she will most likely be recommended to wear a prenatal bandage.

During the entire period of pregnancy, the bandage performs a dual function. Firstly, it compensates for the increasing load on the anterior abdominal wall due to the development of pregnancy. And it does not allow further thinning and weakening of the muscles.

Secondly, the prenatal bandage keeps the position of the abdominal organs in their physiological position, preventing their ptosis and prolapse of the small intestine loops into the inguinal canal. Thus, the appearance of a hernia in a pregnant woman is prevented, or the condition improves with an already existing similar pathology.

The treatment of inguinal hernia is described in detail in the video:

In any case, surgical removal of a hernia in pregnant women is not performed due to possible complications during the operation itself. The tactics of planning and managing childbirth with a hernia in pregnant women is built in accordance with the current state of the existing pathology. So, with a small amount of hernia and the degree of prolapse of internal organs into the hernial sac, it is possible to carry out normal childbirth, but with the control of the hernia by the obstetrician's hand during childbirth. If there is a risk of hernia incarceration, a caesarean section and simultaneous excision of the hernia during the main operation are indicated.

If during the course of pregnancy and childbirth there is a weakening of the fixation of the muscles of the anterior wall of the abdomen, then there is a threat of the emergence of another pathology of the postpartum period. A hernia after childbirth is formed for the same reasons as during pregnancy. However, in such cases, labor activity - attempts and contractions - play an important role in its occurrence. During attempts, not only the contraction of the myometrium occurs during the period of expulsion of the fetus, but also the pressure in the abdominal and pelvic cavity increases significantly. Which serves as a trigger for the formation of a hernia or infringement of an existing one. In all other aspects of occurrence, symptoms, treatment and prevention, a postpartum hernia is not much different from a hernia that occurs during pregnancy.

Pregnancy is a time that all women remember with affection, despite how difficult it is for them. During this period, a woman is very vulnerable, so you should pay a lot of attention to your own health, and, consequently, the health of your unborn child.

During pregnancy, the abdominal muscles have a very large load and because of this they can weaken and lose their tone. That is why at this time women are in the so-called "risk zone" for the occurrence of an ailment called a hernia.

Hernia during pregnancy can be of two types: umbilical and inguinal. In order for this ailment not to cause discomfort, you should know as much as possible about it: what are the factors that affect its appearance, symptoms, as well as existing methods of treatment and prevention.

Factors of hernia during pregnancy.

Umbilical hernia during pregnancy.

Umbilical is called the protrusion of the internal organs of the abdominal cavity through the umbilical ring. It does not have any painful manifestations, it is easily set inside and at the same time, it can make a characteristic sound.

Factors that cause an umbilical hernia:

• Predisposition. Even if in very early age a woman was diagnosed with this ailment, but over time it passed, then the probability of its occurrence during pregnancy is quite high;
• Weakened abdominal muscles. Due to the heavy load, the muscles lose their former tone;
• The cause may also be excess weight before pregnancy;
• Multiple pregnancies, repeated pregnancies, or a large fetus can also cause a hernia.

You need to carefully study all the factors in order to protect yourself from its occurrence.

Inguinal hernia during pregnancy.

An inguinal hernia is usually called a hernia, in which fragments of organs located in the abdominal cavity enter the inguinal canal.

It is rarely diagnosed in women, but it is possible during pregnancy. You need to figure out what are the reasons for its appearance:

• Increased intra-abdominal pressure, which is associated with an increase in the size of the uterus;
• There are also accompanying factors that can cause a hernia: heavy lifting and significant physical exertion, chronic cough and constipation.

Hernia in pregnant women: symptoms.

Symptoms of an umbilical hernia can be seen immediately and with the naked eye - this is a kind of bump in the navel area, when pressed, it is easily set inside. It does not affect the state future mother because it doesn't cause any pain.

Inguinal hernia is also very easy to recognize, although it is much less common. A soft and painless protrusion appears in the groin area. An increase in the size of the fetus can also cause an increase in protrusion, as intra-abdominal pressure increases. This can cause pain and discomfort.

It becomes larger in an upright position and protrudes with straining and physical exertion. The main danger is the infringement of the internal organs that are inside the hernial sac.

Treatment and prevention.

If an umbilical hernia occurs, you should consult a doctor, and he will decide what to do next - whether surgery is needed or you can do without it.

The best prevention of this disease during pregnancy is considered to be wearing a bandage. It will serve as an excellent assistant for the abdominal muscles, and during pregnancy this is exactly what you need. Doctors recommend a bandage to everyone, both to those mothers who have a hernia, and to those who do not have it. It will allow you to slightly relieve the load from the lower back, and also protect against stretch marks.

The only way to treat an inguinal hernia is surgery, but during pregnancy it will not be done, the only exception will be if there is an infringement.

In this case, the best prevention would also be: gymnastics, massage, and, of course, wearing a bandage. It is worth paying attention to the diet so that there is no constipation and bloating.

Many women also complain that they have a hernia after childbirth. It may appear due to the fact that the muscles have not yet acquired their usual tone after the divergence. In this case, you need to contact the surgeon, and he will give the necessary recommendations.

Taking care of your health is taking care of the health of your future baby.