How dangerous is a hernia during pregnancy?

An inguinal hernia is a disease in which several or one organ migrates at once through the inguinal canal to the groin area. During pregnancy, the risk of this disease rises several times, due to the fact that an increase in the size of the fetus provokes an increase in intra-abdominal pressure. So, the organs under the influence of the buoyant force move out of their normal anatomical position in the area where the resistance is less, that is, the inguinal zone.

The anatomical and physiological features of the inguinal canal made this place quite vulnerable. Most often, intestinal loops, omentum, often even the bladder protrude through a thin canal, less often - the spleen or kidneys.

Anatomy of the inguinal canal

The channel is a thin lumen up to 5 centimeters long. It is located between the layers of muscles, ligaments and fascia. A thin tube originates in the peritoneal cavity, then it goes forward and down. A canal is pumped in the groin area, where it is surrounded by strengthening muscles. Normally, in women, there is a round ligament of the uterus, in men - the spermatic cord.

During the period of intrauterine development, this channel gradually closes, and by birth it is completely closed.

However, there are a number of factors that provoke either a violation of the closure of the channel, or weakness of the trailing muscles. This plays a role in the formation of a hernia in pregnant women. In addition, this channel can open even with the absolute norm of the channel structure.

There are other reasons that predispose to the development of a hernia during pregnancy:

• excess body weight , which also increases intra-abdominal pressure due to the fact that the omentum grows with adipose tissue;
• muscle weakness , if a woman has never led an active lifestyle, and her muscles are not able to keep the groin canal in good shape;
• the presence of such persistent symptoms: constipation, increased gas formation, coughing and frequent sneezing, they contribute to increased pressure in the abdomen;
• heavy power loads during pregnancy.

Varieties of inguinal hernia

Inguinal hernia during pregnancy is variable, which determines not only the symptoms, but also the methods of treatment.

There are such types:

1. Actually inguinal.
2. Oblique - the contents of the hernia sac are transported through the entire canal.
3. Direct - occurs when the elements of the peritoneum are pressed directly under the skin.
4. Combined hernia is a combination of direct and oblique protrusion.
5. Interstitial - its location is determined in the structure of the external oblique muscle.

Clinical picture

An inguinal hernia during pregnancy is no different from any other hernia, and has a number of related specific and general symptoms.

The first group of signs includes:

1. At the beginning of the development of the disease, a woman complains of vague pains in the lower abdomen, which are difficult to localize. Often a girl explains this as a temporary discomfort due to pregnancy. However, as the patient's hernia grows, the doctor is told the exact location of the pain. It should be remembered that pain is the leading symptom of almost any hernia. Periodically, the pain may disappear, but with power loads, discomfort always returns.
2. The appearance of a tumor-like formation in the inguinal region. At first, a woman notes a slight swelling, which actively grows over time. As the tumor grows, it becomes more painful, causing more and more discomfort. Sometimes when pressed with a finger or in a horizontal position, the swelling disappears.
3. In women, the presence of a hernia is associated with painful menstrual cycles.
4. When parts of the urinary system fall out, the function of urination is disturbed: the process is accompanied by discomfort and pain.
5. When parts of the intestine fall out, symptoms of digestive dysfunction are observed. A woman may complain of constipation, abdominal pain.
6. The severity of discomfort and pain directly correlates with the stage of pregnancy: the longer the period, the more inconvenience.

Common symptoms include:

• increase in body temperature;
• exhaustion, rapid fatigue even from simple work;
• irritability and bad mood;
• sleep disturbance.

However, one cannot fully refer to the group of non-specific symptoms, since they are signs of many diseases. Such manifestations also accompany the period of pregnancy without pathologies.

Diagnostics

What to do if there are signs of an inguinal hernia? First of all, you need to consult a doctor. The doctor will also tell you if you can give birth. The specialist will first conduct a general examination, which includes studying the patient's condition, her hernia, palpation of the protrusion. In addition, the doctor needs to study the following manifestations: a symptom of a cough shock, a type of hernia. Then the doctor prescribes instrumental diagnostic methods.

These include:

1. X-ray diagnostics.
2. Bimanual diagnosis - the method is carried out through the vagina and intestines. The method provides information about the presence of ovaries or other genital organs of the patient in the hernial sac.
3. Ultrasound . Ultrasound allows the diagnostician to evaluate the contents of the bag.

The specifics of labor activity

The period of childbirth is a difficult time, requiring certain costs from the mother's body. So, the presence of a hernia cuts off a number of resources and opportunities for the expectant mother. The birth of a child in a natural way is allowed only if the protrusion is not large.

Directly during childbirth, the doctor carefully monitors the condition of the hernia, and makes every effort so that it does not get pinched. In this case, the opportunity for a woman to give birth is not limited.

In the case when the hernia is large, and the puerperal has any diseases, the mother is offered to perform a caesarean section. After a successful birth, the pressure inside the abdomen is balanced, comes to a normal position, and the hernia can go away without any additional manipulations.

Complications

The most common complication of hernial pathology is strangulation. This term refers to a sudden state that is characterized by the loss of organ function. The latter is clamped in the hernial ring, as a result of which the local blood circulation stops or significantly worsens. Such a complication does not develop without a reason. The main factor in the formation is considered to be a sudden strong increase in intra-abdominal pressure.

As the infringement develops, necrosis processes occur - the partial death of living tissues. In the future, this condition threatens with peritonitis.

Treatment

The most effective way to cure pathology is surgery. However, this is not a planned operation, and it is carried out only when there are factors that threaten the life of both the unborn child and the woman herself.

To prevent the development of a hernia, the doctor will recommend wearing a special medical bandage that will keep the muscles in good shape. It must be worn until the very end of pregnancy. Also useful are massages, elementary gymnastic exercises.