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Ventral hernia containing a term gravid uterus: A rare challenge in surgical and obstetric management
José Maria Zepeda Torres1, Juan Daniel Flores Carlos1, Luis Osvaldo Suárez Carreón1
1General Surgery, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social.
A 28-year-old woman at 34.5 weeks of gestation presented with an incarcerated ventral hernia containing the gravid uterus and overlying skin ulceration, one year after a cesarean section. Magnetic resonance imaging revealed a large infraumbilical defect with herniation of the uterus and small bowel. Given the risk of rupture and infection, an urgent cesarean delivery followed by primary abdominal wall repair without mesh was performed. Both maternal and neonatal outcomes were favorable. Gravid uterine herniation through an incisional defect is extremely rare and requires individualized multidisciplinary management, with primary repair being a safe option in contaminated or high-risk settings.
A 28-year-old woman at 34.5 weeks of gestation presented with an incarcerated ventral hernia containing the gravid uterus and overlying skin ulceration, one year after a cesarean section. Magnetic resonance imaging revealed a large infraumbilical defect with herniation of the uterus and small bowel. Given the risk of rupture and infection, an urgent cesarean delivery followed by primary abdominal wall repair without mesh was performed. Both maternal and neonatal outcomes were favorable. Gravid uterine herniation through an incisional defect is extremely rare and requires individualized multidisciplinary management, with primary repair being a safe option in contaminated or high-risk settings.
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