Hernia

INFORMATION FOR WOMEN WHO HAVE HERNIA DURING PREGNANCY OR BREASTFEEDING

The information provided below is for readers based in the United States of America. Readers outside of the United States of America should seek the information from local sources.

What is hernia during pregnancy?

Hernia, or herniation, is the protrusion of part of an internal organ through the wall of a body cavity, often a wall whose connective tissue and/or muscle contains a weak area. In pregnancy, various types of hernia can occur, because of the growing uterus placing increasing pressure in all directions, and because of stretching of the walls of body cavities. One type of hernia that pregnancy can cause, or worsen, is an inguinal hernia, in which a section of intestine, or omentum (an apron-shaped layer of membrane that is attached to abdominal organs), protrudes into the inguinal canal in the groin. A less common type of groin hernia is a femoral hernia, in which a weakened abdominal wall and pressure from the growing womb cause abdominal contents to protrude into the femoral canal. Protrusion of abdominal contents through abdominal wall muscles, not into a canal, is called a ventral hernia. One type of ventral hernia is called an incisional hernia, which is characterized by protrusion of organ parts through a healed incision line, such as the incision that you may have had from a cesarean section for a previous pregnancy. An umbilical hernia is the protrusion of abdominal contents through the umbilicus (the belly button). This develops commonly in pregnancy, due to forward pressure from the growing womb against an abdominal wall that is weakened right around the umbilicus. Also possible during pregnancy is a diaphragmatic hernia, in which organ parts protrude through the diaphragm that separates the abdominal and chest (thoracic) cavities. The most common type of diaphragmatic hernia is called hiatal hernia, in which the stomach protrudes upward through whats called the esophageal hiatus.

How common are hernias during pregnancy?

Different types of hernias occur at different rates. Umbilical hernia is fairly common among mothers-to-be, developing in approximately 8 out of 1,000 pregnancies. Diaphragmatic hernias are fairly rare during pregnancy, although they can lead to severe complications when they do occur.

How is a hernia diagnosed?

Hernias are diagnosed based on your history, your symptoms, and signs that the doctor can find on physical examination. This process can point to a likely hernia, which imaging studies can then reveal. In the case of an umbilical hernia, for instance, the umbilicus would bulge, and this would worsen when you cough. If intestines begin to become strangulated, you also would feel abdominal pain and tenderness centered on the umbilicus, which would be surrounded by reddened skin. Constipation or vomiting also might occur. With a hiatal hernia, you would feel heartburn, you may experience regurgitation of food, you may have difficulty swallowing, shortness of breath, and sore throat, plus you may have darkened stools, which are indicative of bleeding in the stomach. Organs, such as intestines, can become incarcerated (trapped) in a hernia, meaning that they cant get out without surgery no matter how the tissues are pulled or manipulated from the outside.

Does a hernia cause problems during pregnancy?

Yes. Hernias can lead to various complications, depending on the type of hernia. Umbilical and incisional hernias, for instance, can entrap loops of intestine, leading to life-threatening situations.

Does hernia during pregnancy cause problems for the baby?

The baby can have problems in cases when a hernia is complicated if it puts the mothers health and life in danger. With an umbilical hernia, for instance, strangulation or incarceration of organs can harm the mother seriously and/or require immediate surgery, in which case there is a higher risk of premature delivery and spontaneous abortion (miscarriage).

What to consider about taking medications when you are pregnant:

  • The risks to yourself and your baby if you do not treat the hernia
  • The risks and benefits of each medication you use when you are pregnant
  • The risks and benefits of each medication you use when you are breastfeeding

What should I know about using medication to treat hernia during pregnancy?

Hiatal hernia can exacerbate gastroesophageal reflux disease (GERD), meaning that acid from the stomach reaches the esophagus causing a burning sensation, sometimes coughing, and, if it continues for a long time, long term damage. This situation is treated with agents that reduce acid production, called H-2 antihistamines; cimetidine, famotidine, nizatidine, ranitidine. Stronger medications, called proton pump inhibitors include lansoprazole and omeprazole. Ranitidine, cimetidine, and famotidine are considered to be fairly safe in pregnancy as are lansoprazole and omeprazole.

Who should NOT stop taking medication for hernia during pregnancy?

Women with GERD symptoms related to hiatal hernia should continue to take their medication since the condition has a major negative impact on quality of life and the benefit of the medications outweighs any risks.

What should I know about choosing a medication for hernia during pregnancy?

You may find Pregistrys expert reports about the individual medications to treat hernia here. Additional information can also be found in the sources listed at the end of this report.

What should I know about taking a medication for my hernia when I am breastfeeding?

Medications given for GERD connected with hiatal hernia, are generally considered safe in women who are breastfeeding, even if tiny amounts of the drugs enter the milk.

What alternative therapies besides medications can I use to treat hernia during pregnancy?

Many hernias can be managed with a watchful waiting approach with restrictions on physical activities, but when strangulation, incarceration, and other complications develop they often require surgery.

What can I do for myself and my baby when I have a hernia during pregnancy?

You should cooperate with your physicians in terms of medications, recommendations for limitations of physical activity and, when necessary, surgery.

Resources for hernia in pregnancy:

For more information about hernia during and after pregnancy, contact http://www.womenshealth.gov/ (800-994-9662 [TDD: 888-220-5446]) or read the following articles:

 

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General information

It is very common for women to worry about having a miscarriage or giving birth to a child with a birth defect while they are pregnant. Many decisions that women make about their health during pregnancy are made with these concerns in mind.

For many women these concerns are very real. As many as 1 in 5 pregnancies end in a miscarriage, and 1 in 33 babies are born with a birth defect. These rates are considered the background population risk, which means they do not take into consideration anything about the health of the mom, the medications she is taking, or the family history of the mom or the baby’s dad. A number of different things can increase these risks, including taking certain medications during pregnancy.

It is known that most medications, including over-the-counter medications, taken during pregnancy do get passed on to the baby. Fortunately, most medicines are not harmful to the baby and can be safely taken during pregnancy. But there are some that are known to be harmful to a baby’s normal development and growth, especially when they are taken during certain times of the pregnancy. Because of this, it is important to talk with your doctor or midwife about any medications you are taking, ideally before you even try to get pregnant.

If a doctor other than the one caring for your pregnancy recommends that you start a new medicine while you are pregnant, it is important that you let them know you are pregnant.

If you do need to take a new medication while pregnant, it is important to discuss the possible risks the medicine may pose on your pregnancy with your doctor or midwife. They can help you understand the benefits and the risks of taking the medicine.

Ultimately, the decision to start, stop, or change medications during pregnancy is up to you to make, along with input from your doctor or midwife. If you do take medications during pregnancy, be sure to keep track of all the medications you are taking.


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