Umbilical hernia repair in pregnant patients: review of the American College of Surgeons National Surgical Quality Improvement Program
Acute abdomen; Incarceration; Pregnancy; Strangulation; Umbilical hernia
© 2017, Springer-Verlag France SAS. Background: Umbilical hernias present commonly during pregnancy secondary to increased intra-abdominal pressure. As a result, umbilical hernia incarceration or strangulation may affect pregnant females. The purpose of this study is to detail the operative management and 30-day outcomes of umbilical hernias in pregnant patients using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Methods: All female patients undergoing umbilical hernia repair during pregnancy were identified within the ACS-NSQIP. Preoperative patient variables, intraoperative variables, and 30-day patient morbidity and mortality outcomes were investigated using a variety of statistical tests. Results: A total of 126 pregnant patients underwent umbilical hernia repair from 2005 to 2014; 73 (58%) had incarceration or strangulation at the time of surgical intervention. The majority of patients (95%) underwent open umbilical hernia repair. Superficial surgical site infection was the most common morbidity in patients undergoing open umbilical hernia repair. Conclusions: Based on review of the ACS-NSQIP database, the incidence of umbilical hernia repair during pregnancy is very low; however, the majority of patients required repair for incarceration of strangulation. When symptoms develop, these hernias can be repaired with minimal 30-day morbidity to the mother. Additional studies are needed to determine the long-term recurrence rate of umbilical hernia repairs performed in pregnant patients and the effects of surgical intervention and approach on the fetus.
Haskins, I., Rosen, M., Prabhu, A., Amdur, R., Rosenblatt, S., Brody, F., & Krpata, D. (2017). Umbilical hernia repair in pregnant patients: review of the American College of Surgeons National Surgical Quality Improvement Program. Hernia, 21 (5). http://dx.doi.org/10.1007/s10029-017-1633-8