Incisional Hernia in Pregnancy at the University of Port Harcourt Teaching Hospital, Southern Nigeria

Abstract

Background: Aim: incisional hernias occur through a weakness at the site of abdominal wall closure after surgery and is a common condition encountered in day to day surgical practice. It lends itself to multiple and varied aetiological factors. Despite recent advances in the management of incisional hernias, the recurrence rate is still high. Incisional hernia is uncommon in pregnancy, however when it occurs serious and life-threatening complications may arise. Thus there is a need to revisit the possible aetiological factors that may give rise to incisional hernia in our locality so as to prevent them. To our knowledge no such study has ever been undertaking here. Materials and methods This is a five-year retrospective survey conducted at the antenatal clinic of the university of Port Harcourt Teaching hospital in southern Nigeria between January 2008 to December 2013. A total of one hundred and seven patients with incisional hernia were identified and some aetiological factors for incisional hernia in the patient were deciphered. Each patient’s abdomen was examined to confirm the presence of incisional hernia, and type of surgical incision used. All these were collated and analysed. Results: Obesity was the commonest risk factor 78 (72.9%), while wound sepsis accounted for 61 (57.0%) Nearly all patients had longitudinal incisions 105 (98.1%) while for some 11 (10.3%), there were no identifiable risk factors. Also, Caesarean section accounted for majority of the surgeries that led to incisional hernia in the study population 72(67.3%) followed by myomectomy. Emergency surgeries were complicated by incisional hernia than elective Conclusion: This study found that the commonest aetiological factors for incisional hernia in our locality but not limited to: Obesity, wound sepsis, emergency surgeries as well as longitudinal incisions. Interestingly these are all modifiable risk factors and are amenable to health education and sound surgical techniques.