Pregnancy and ventral hernia repair

Reluctance to repair anterior abdominal wall hernias in women of childbearing age is probably unjustified. A unique series is described of 27 women who gave birth to 41 full-term babies following repair of an anterior abdominal wall hernia with no recurrence of the hernia. Nineteen had primary and recurrent umbilical hernias and an incisional hernia in a low transverse incision repaired by the onlay darn technique and have produced 29 babies. Eight had umbilical hernias, gross diastasis of the recti and post-cesarean section vertical incisional hernias repaired by the Shoelace technique followed by 12 full-term pregnancies. Little is written about the fate of the abdominal wall subjected to pregnancies following repair of ventral hernias, since the majority of women having these hernias repaired are past the child-bearing age or are warned off further pregnancies by their doctors or undergo tubal ligation with the hernia repair. The Shoelace repair is described, stressing its advantages over mesh hernioplasties in women who wish to have further pregnancies. There is apparently no reason to refuse to repair these hernias. There are even positive indications in view of serious complications associated with pregnancy in the presence of an anterior wall hernia. Prosthetic mesh tends to contract and harden and may seriously interfere with abdominal expansion in pregnancies so these hernias are probably best repaired by the Shoelace technique.