What happens if you have an umbilical hernia while pregnant?
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| Umbilical Hernia During Pregnancy |
Umbilical Hernia During Pregnancy: What You Need to Know
While umbilical hernias can occur at any age, they do not spare the pregnancy period. Zoom in on this particular hernia, and what happens when it occurs in a pregnant woman.
A hernia is the passage of an organ, usually the small intestine, through a natural opening. We speak of an inguinal hernia when the hernia occurs above the groin crease, a femoral or crural hernia when it affects below the groin crease, and an umbilical hernia when the hernia occurs at the navel (umbilicus).
What is an umbilical hernia?
Umbilical hernia is characterized by the pushing of a part of the small intestine and/or visceral adipose tissue towards the navel, due to muscular weakness at the level of the abdominal wall. In short, the intestine or abdominal fat crosses the muscular barrier, creating a kind of bump at the level of the navel , whereas all these viscera should remain well behind the muscular wall.
Although this condition mainly affects infants and young children, it can also affect adults, particularly pregnant women.
Why can this type of hernia occur during pregnancy?
Umbilical hernia can occur in pregnant women due to increased pressure in the mother's abdomen as the baby grows. Gradually, this increasing pressure can push intestine and other abdominal tissues through a weakened area of the abdominal wall: the navel or linea alba.
"This occurs particularly in women with a large baby , in those who have gained a lot of weight, or who have large babies in relation to their body shape ," midwife Rachel Halimi tells us, due to " increased pressure at the navel ."
Fortunately, the majority of so-called "pregnancy" umbilical hernias resolve spontaneously and gradually after childbirth.
Pain in the navel and other symptoms, when they exist
Umbilical hernia is often not very painful or even asymptomatic.
However, symptoms may occur, such as:
- a lump or swelling around the belly button;
- moderate and very localized pain at the navel level.
Other, rarer symptoms are also more worrying and should prompt you to consult a doctor very quickly: nausea, vomiting , loss of transit, etc. (see paragraph on risks)
What is the link with diastasis recti?
Diastasis recti, or abdominis, refers to the separation of the superficial abdominal muscles (the rectus abdominis muscles , better known by the cute name of “six-pack abdominis”). Usually joined at the navel line (called the white line or linea alba) by connective tissue, the rectus abdominis can separate when this tissue stretches excessively. Since the uterus can exert too much pressure on the abdominal muscles, diastasis recti can occur during pregnancy.
Diastasis and hernia can be associated , but they are two different things, since in the case of an abdominal diastasis there is no "hole" in the tissues, while in the case of a hernia we can speak of a "hole" at the level of the part connecting the abdominal muscles.
Umbilical or linea alba hernia (see below) promotes the appearance of a diastasis , but a priori the reverse is not true.
Hernia of the white line
Another type of hernia can be associated with a diastasis, an umbilical hernia, and/or occur during pregnancy: it is the hernia of the white line , or epigastric hernia, which is the consequence of a "tear" of the white line, this area of connective tissue similar to a ligament, connecting the abdominal muscles together in the middle of the belly.
What are the risks of an umbilical hernia in pregnant women?
The main risk of an umbilical hernia during pregnancy is intestinal obstruction , if intestinal contents become trapped in the intestinal area that protrudes. This can result in the cessation of transit, nausea, vomiting, and necrosis of the area, which is no longer irrigated by blood circulation. Surgery is then necessary, under general anesthesia.
Note that this complication is rare during pregnancy , umbilical hernia simply requires some precautions and monitoring to avoid this.
Strangulated umbilical hernia, an emergency
If the intestine twists inside the hernia (or hernial sac), the intestine is no longer vascularized, and it dies. This is called a "strangulated hernia". This is a medical emergency.
How to prevent the occurrence of an umbilical hernia and avoid complications?
As we have seen, umbilical hernias can occur during pregnancy due to increased pressure in the abdomen as the baby grows and the uterus takes up space. Rapid and significant weight gain could promote the occurrence of an umbilical hernia, a hernia of the white line, or even an abdominal diastasis.
For Rachel Halimi, midwife, healthy living and diet are therefore at the heart of preventing these anatomical complications of pregnancy, although they can unfortunately occur despite an irreproachable lifestyle, due to other factors (smoking, heredity, etc.).
To avoid or limit the progression of a diastasis or an umbilical hernia, we will take care to:
limit weight gain during pregnancy;
avoid carrying heavy loads;
do gentle physical activity, suitable for pregnancy (Pilates, yoga, swimming, gentle gym, etc.).
Be careful not to overexert the abdominal muscles, as this could increase intra-abdominal pressure and produce the opposite effect. It is best to be accompanied by a health professional, such as a physiotherapist .
Can you live with an umbilical hernia? Does it go away after pregnancy?
If it does not cause complications, an umbilical hernia is not very serious in itself, especially if it is asymptomatic. Monitoring is sufficient, but necessary, with a digestive surgeon, to discuss treatment options and the course of action.
Note that when the umbilical hernia is related to pregnancy, it is common for it to decrease in size or even resolve after childbirth, but this can take several months.
Surgery: when should you operate?
As we have seen, it is necessary to operate when a complication arises: an intestinal occlusion or a strangulated hernia are medical emergencies which require surgery.
Apart from these complications, if there is no swelling of the hernia over time, and if the hernia does not cause symptoms, there is no need to operate. As we have seen, an umbilical hernia due to pregnancy can gradually resolve itself after childbirth.
If a hernia is symptomatic and discovered during pregnancy, surgery will be performed after the pregnancy, except in emergencies (intestinal obstruction, strangulated hernia).
Finally, if an umbilical hernia is discovered before a possible pregnancy, the patient wishing to become pregnant is generally warned: the hernia risks increasing during the pregnancy and becoming symptomatic.
