Hernia after C-Section: causes, risks, and treatment

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All pregnant women want to give birth to their babies in the most natural way, but sometimes due to some medical reasons or incorrect posture of the baby cesarean delivery is recommended by the doctor. In cesarean delivery, an incision is given to the abdomen and uterus to assess the baby.

There are few complications of c-section and among them, one complication is an abdominal hernia. This article describes the causes, risks, and treatment of hernia after C-section.

Hernia after C-Section

What is a Hernia?

When a part of the body protrudes or pushes through another part of the body where it is not supposed to be then it is known as a hernia. After cesarean delivery when abdominal lining comes through the surgical incision then it is an incisional hernia.

Risk of hernia is more in women if they:

  • are obese
  • have undergone cesarean delivery and have a large cesarean incision
  • have diabetes
  • have weak tissues
  • Usually, the incisional hernia does not cause symptoms beyond their physical characteristics, but they don’t go away without treatment. After the c-section surgical intervention is the sole treatment for an incisional hernia.

Are Hernias Common after a C-section Birth?

The occurrence of hernia in women after C-section delivery is rare, there is a possibility for sure.

According to some studies it is calculated that nearly 2 out of 1000 women have a hernia if they deliver a baby by c-section and it is then corrected by surgical intervention. In cesarean delivery, an incision is given on the abdomen in the top to bottom manner due to which these hernias tend to be more apparent in women. Incisions that are given side to side had lower instances of a hernia as compared to that of c-section.

Causes of Hernia after Cesarean Delivery

The causes of hernia after cesarean delivery in a woman depends on a variety of factors. Some of those can be related to process, while a few of them may be related to the physical characteristics of a woman. Following are the causes of hernia in a woman after c-section:

Risk of hernia increases in a woman who has weaker abdominal tissue which fails to keep the abdomen in place.

  • Gestational diabetes can increase the risk of hernia.
  • Obesity or overweight can increase the risk of hernia. Because due to pressure on the abdomen throughout the pregnancy and delivery, linings of the abdomen are pushed through incision.
  • For a successful delivery larger incision is given due to which chances of hernia increase.

Risk Factors

There are few factors which can increase the risks of a hernia after a cesarean delivery which are as follows:

Chances of a hernia increases if a woman has had multiple pregnancies and all of them resulted in cesarean delivery.

  • Hernias may occur just after the delivery or they may take 3 years following the delivery.
  • Risk of a hernia after c-section increases if a woman has a pre-existing history of abdominal hernias because the abdominal wall is already weak from the previous cases.
  • Before proceeding with a cesarean delivery the doctor must know about the history of hernias or surgeries.

Symptoms of Hernia after C-Section

Following are the symptoms of hernia after c-section:

  1. Abdominal bulge

This is one of the most common symptoms of hernia after c-section. A hernia is visible in the form of a bulge, which appears to emerge from the region of cesarean incision. The bulge can be seen in the area of surgical scar or sometimes in the entire region. Some women may have hernia just after the delivery but they notice it after months following the delivery.

The bulge is more evident when a woman stands straight and stretch or when she tries to lift an object to a height. She may also feel it when she cough. Diagnosis of hernia is difficult because the skin on the abdomen may appear loose, dimpled, or bulging as the uterus begins to shrink and the body starts healing the wound.

  1. Abdominal pain

When the bulge in the stomach is more then it can cause pain and discomfort. This is the most confusing symptom because most women experience little pain due to cesarean delivery. The healing process of c-section and the abdominal bulge may work together to cause discomfort. So, if discomfort continues even after the healing process is completed then it indicates the presence of a hernia.

  1. Nausea and Constipation

Cesarean section affects the entire abdominal region including the intestines and the stomach. Due to which if there is any disturbance in the position of the intestines then there is inefficient processing of the food which could lead to constipation. If there is a disturbance in the stomach by which the stomach gets irritated then there is nausea and vomiting.

Diagnosis of Hernia after C-Section

If a hernia is severe then doctors just look at the abdomen and diagnose it. But some conditions occur after a cesarean might make it difficult to diagnose, these conditions are:

  • Abscess
  • Uterine rupture
  • Wound infection
  • Hematoma
  • Endometriosis
  • Doctors may do a CT scan or an ultrasound to confirm the diagnosis of a hernia or to assess if the bowel is trapped inside the hernia.

Complications

Following are the complications of hernia after cesarean delivery:

  • Blockage of bowel
  • Bowel perforation
  • Bleeding inside the body
  • Abdominal cavity fills with fluid

Treatment of Hernia after C-Section

For an incisional hernia surgery is the usual treatment. But surgery is not recommended by the doctors unless a woman is having certain symptoms. Surgery is recommended in the following situations:

If the hernia is getting much bigger and more noticeable

  • If the hernia is causing discomfort due to which a woman is unable to complete her day to day activities
  • If the bowel is trapped in the hernia and causing pain and discomfort
  • There are no medications that can make hernia smaller. Abdominal binder, which is an elastic belt that keeps hernia from protruding is preferred by some women. This binder just helps to alleviate the symptoms. Surgery is an only permanent treatment that reduces the appearance of the hernia.

Conclusion

Hernia after c-section is rare but the possibility of its occurrence is sure. Usually one of the best successful procedures for an incisional hernia is surgery. If a woman wants to have another baby then she is at greater risk for recurrence. So, doctors recommend them to wait for the next pregnancy just to reduce the risk of recurrence of hernia after surgical repair.

References

https://pubmed.ncbi.nlm.nih.gov/31785469/

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