Incisional hernia after cesarean section: a systematic review

Publication date: Available online 14 November 2019Source: European Journal of Obstetrics &Gynecology and Reproductive BiologyAuthor(s): Cecilie B Paulsen, Dennis Zetner, Jacob RosenbergAbstractIncisional hernia is a well-known complication following abdominal surgery. A frequently performed abdominal operative procedure is cesarean section. In 2015 the median cesarean section rate in Europe was 27% with rates up to 57% when looking at individual countries, and the rates of cesarean sections increased with 4% in Europe from 2010 to 2015. Nonetheless, the occurrence of incisional hernia subsequent to cesarean sections is uncertain. The aim of this study was to investigate the reported occurrence of incisional hernia after cesarean section.We included original studies with women who had given birth at least once through a cesarean section. For studies to be eligible for inclusion, a minimum follow-up period of six months as well as a population of ten or more included patients were required. The primary outcome was occurrence of incisional hernia after cesarean section. The secondary outcomes were frequency of subsequent hernia operations, and if the hernia occurrence differed between midline and lower transverse incision, and between acute and elective cesarean section. Three databases were systematically searched: PubMed, Embase, and the Cochrane Library. The review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guideline ...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research

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ConclusionsIf possible, elective ventral repair should be postponed until after last pregnancy. A non-mesh repair seems appropriate for smaller primary ventral hernia in women who plan future pregnancies. Umbilical hernia during pregnancy seems very rare and seldom requires repair pre- and post-partum. Routine practice of umbilical hernia repair in combination with cesarean section cannot be recommended. PROSPERO: CRD42017073736.
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