Hernia in pregnancy-Does it matter?

Introduction: Pregnancy is a risk factor for hernia development. This review studies the natural history and outcomes of hernias in pregnant women treated in the Hong Kong West Cluster. Methods: This is a cluster-wide, retrospective descriptive study. Electronic medical records of women attending Hernia Clinics at Tung Wah Hospital or Queen Mary Hospital or those emergently admitted into the surgical department between January 2002 and January 2022 were screened. Inclusion criteria were women with: (i) hernia developed during pregnancy; and (ii) known unrepaired hernia developed prior to pregnancy. Results: Forty-one patients were included. Median age of hernia onset was 31 years old. All patients continued with pregnancy with no hernia complications. None received hernia repair before delivery. Nine out of 41 patients (22.0%) received Caesarean section. Fourteen out of 22 (63.6%) patients with inguinal hernias developed during pregnancy reported hernia disappearance after delivery, of whom five experienced hernia recurrence. One out of five patients with ventral hernia developed during pregnancy experienced hernia disappearance after delivery with no recurrence. 43.9% received hernia repair after delivery. Conclusions: It is safe to adopt conservative management in pregnant women. Vaginal delivery is not contraindicated. We recommend watchful waiting during pregnancy and repair after delivery.