Umbilical hernia during and after pregnancy

• An umbilical hernia is a protrusion of a hernial sac through the patient's abdominal wall that is defective.
• The umbilical hernia is located around the umbilicus, so the protrusion or protrusion of the hernia sac occurs in that area. It is common in pregnant women.
• The only solution to treat umbilical hernia definitively is surgery, which is recommended for pregnant women after childbirth.

A hernia is the bulging or protrusion of an organ through a defect in the abdominal wall. When the abdominal wall weakens, it may tear. This tear causes the abdomen to push on the peritoneum and the peritoneum protrudes outwards, manifesting itself in the patient as a kind of hernia bulge or sac.

An umbilical hernia is a type of hernia located in or around the navel. 

Some of the causes of an umbilical hernia are: heavy physical exertion, obesity, pregnancy, etc.

During pregnancy, the most common hernia that occurs is an umbilical hernia, which does not pose any complications or danger to the pregnancy.

Umbilical hernia in pregnant women occurs mainly during the second half of pregnancy and is mainly due to the enlargement of the uterus. It can also occur after pregnancy due to heavy abdominal straining during childbirth.

Umbilical hernias are usually congenital, i.e., prior to pregnancy there is usually a defect in the abdominal wall that implies a propensity for the appearance of the hernia defect, which becomes effective during pregnancy due to the increased pressure exerted.

An umbilical hernia usually has no symptoms, but sometimes a kind of bulge or enlargement of the umbilicus can be seen. In particular, this lump or bulge may appear during abdominal straining.

Another symptom experienced by pregnant women may be slight pain in the area, which may also appear when exerting oneself, such as when bending over or laughing. If the pain is severe, the doctor recommends a maternity girdle (abdominal binder).

Usually, umbilical hernias do not pose any risk to the pregnant woman or the baby, although sometimes when they are larger, the intestines can become trapped by the hernia and what is called "hernia strangulation" can occur, which can cut off the blood flow in the area and be dangerous for the mother.

This is why, in order to avoid future complications when a pregnant woman has an umbilical hernia, she is advised not to gain too much weight during pregnancy and to avoid heavy abdominal straining.

The best thing to do when you suspect you may have an umbilical hernia is to consult a specialist to confirm the diagnosis and recommend the best treatment for the pregnant woman, both during and after pregnancy.

Sometimes an umbilical hernia does not require any treatment when there are no symptoms. However, it is true that sometimes an umbilical hernia in pregnant women may need to be operated on. 

In this case, the intervention will be carried out when the mother has given birth, never during pregnancy, as it could pose a risk to the foetus.

As long as the hernia cannot be operated on (during pregnancy, if the mother has not yet given birth), the specialist will recommend some measures to the patient, such as:

• Take care of your diet to avoid being overweight.
• Take gentle, moderate exercise, such as walking.
• Eat a diet rich in fibre to avoid constipation.
• Do not exert yourself abdominally.
• Protect the abdominal area with a special girdle for pregnant women.

With these measures, the patient will prevent umbilical hernia complications, although patients who do not have an umbilical hernia are also advised to follow these measures to avoid the possibility of umbilical hernia.

After pregnancy, the umbilical hernia can be corrected without causing any damage.

After the operation, the patient should also follow some measures to heal the wound:

• Avoid activities that require physical exertion.
• Avoid activities that put pressure on the abdomen.
• Avoid driving.
• Do gentle exercise, such as walking.
• Eat vegetables, fruit, rice, wholemeal bread, etc. In general, foods rich in fibre help to prevent constipation.

Umbilical hernia surgery

In general, umbilical hernia is corrected by means of the hernioplasty technique, which consists of placing a surgical mesh made of synthetic material to correct the defect. 

To perform the surgery, two types of approach can be chosen, open or laparoscopic:

• Open approach: using this technique, which is the conventional one, the specialist makes an incision until the hernia defect is reached, repositions it inside and then places a synthetic mesh that consolidates the abdominal wall.
• Laparoscopic approach: with this technique, the specialist makes 3 or 4 incisions and inserts a laparoscope (a small instrument with a camera on the end that allows the patient to see inside), which facilitates the resolution of the problem. With this technique, a prosthetic mesh is also placed in the abdomen.

The umbilical hernia operation lasts between 30-40 minutes and does not usually present complications, it also improves the patient's quality of life, eliminating all types of discomfort that it may cause.

It should be noted that the most advisable thing to do is to perform the surgery and prevent it from recurring in the future, which is very likely.