Open AccessHerniated near-term pregnancy through an incisional hernia treated with polypropylene mesh: A case report
Author(s) -
Eleje George Uchenna,
Boniface Chukwuneme Okpala,
Enendu Stephen Ejike,
Okeke Paul Mbanefo,
Ejikeme Toochukwu Benjamin
Publication year - 2014
Publication title -
nigerian medical journal/nigerian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2229-774X
pISSN - 0300-1652
DOI - 10.4103/0300-1652.132069
Subject(s) - medicine , incisional hernia , lower segment caesarean section , caesarean section , hernia , gestation , pregnancy , surgery , guideline , general surgery , life saving , obstetrics , medical emergency , pathology , biology , genetics
The management of a large incisional hernia amidst gravid uterus in its sac is a very challenging obstetric entity. Because of the uncommonness of this entity, there has not been any evidence-based guideline regarding the optimal mode of treatment and so treatment is largely individualised. We present the case of a 32-year-old booked G7P6+0 Nigerian woman with two living children who was already booked for elective repeat lower segment Caesarean section (CS) and 'Caesarean' herniorrhaphy at 38 weeks of gestation but only to present at 36-weeks gestation with a 4-hour history of labour pains. She had an emergency lower segment CS 2 years earlier due to obstructed labour but the CS was complicated by wound infection. Examination revealed gravid uterus that herniated through the incisional hernia. She subsequently had emergency lower segment CS with the repair of the hernia with polypropylene mesh. She had uneventful post-operative recovery. Herniated uterus of near-term pregnancy through an incisional hernia has not been reported in our hospital. As in our case, triumphant management required brave but multidisciplinary approach and currently there are emerging management options such as the use of mesh and laparoscopic technique.