Incisional hernia after cesarean section: A systematic review

Paulsen, Cecilie Bøge; Zetner, Dennis; Rosenberg, Jacob

doi:10.1016/j.ejogrb.2019.11.010

Cited by 19 publications

(18 citation statements)

References 26 publications

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“…With advances of blood transfusion, anesthesiology, diversification of surgical methods, improvement of surgical suture materials, cesarean section has become an effective treatment of maternal women [ [1,2]]. However, the risks of postoperative thrombosis, intraoperative bleeding, uterine rupture, and placenta previa of repregnancy after cesarean delivery are significantly higher than those of women delivered via vaginal delivery [3][4][5]. Besides, the surgical site infection after cesarean section is a common yet serious complication, which has raised the attentions of health care providers [6].…”

Section: Introductionmentioning

confidence: 99%

The risk factors and care measures of surgical site infection after cesarean section in China: a retrospective analysis

Cui

2021

BMC Surg

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Background Surgical site infections after cesarean section are very common clinically, it is necessary to evaluate the risk factors of surgical site infections after cesarean section, to provide evidences for the treatment and nursing care of cesarean section. Methods This study was a retrospective cohort study design. Patients undergone cesarean section in a tertiary hospital of China from May 2017 to May 2020 were identified, we collected the clinical data of the included patients, and we analyzed the infection rate, etiological characteristics and related risk factors of surgical site infection after caesarean section. Results A total of 206 patients with cesarean section were included, and the incidence of surgical site infection in patients with cesarean section was 23.30%. A total of 62 cases of pathogens were identified, Enterococcus faecalis (33.87%) and Escherichia coli (29.03%) were the most common pathogens. Both Enterococcus faecalis and Escherichia coli were highly sensitive to Cefoperazone, Meropenem, and Levofloxacin. Logistic regression analyses indicated that Age ≥ 30y (OR 4.18, 95%CI: 1.23–7.09), BMI ≥ 24 (OR 2.39, 95%CI: 1.02–4.55), duration of cesarean section ≥ 1.5 h (OR 3.90, 95%CI: 1.28–5.42), estimated blood loss ≥ 400 ml (OR 2.35, 95%CI: 1.10–4.37) and the duration of urinary catheter ≥ 24 h (OR 3.18, 95% CI: 1.21–5.71) were the independent risk factors of surgical site infection after cesarean section (all p < 0.05). Conclusions Age, BMI, duration of surgery, blood loss and urinary catheter use were associated with higher risk of the surgical site infection after cesarean section. Clinical preventions and interventions are warranted for those population to reduce the occurrence of surgical site infection.

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Section: Introductionmentioning

confidence: 99%

The risk factors and care measures of surgical site infection after cesarean section in China: a retrospective analysis

Cui

2021

BMC Surg

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“…A newly published systematic review reports the rate of incisional hernia to be 0.0–5.6% after caesarean section. A possible reason for the wide range is the large number of midline incisions in some developing countries at the time of the report [ 11 ]. Two larger studies in the review were conducted in high-income countries where transverse incision was recommended to limit the occurrence of incisional hernia [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Bowel obstruction was reported in 0.05 to 0.2% in two large studies, but it is unclear when in relation to the delivery obstruction occurred, and whether surgery was required [ 10 ]. Previous studies have shown an increase in incisional hernia repair rate after multiple caesareans sections [ 11 ]. The rare but severe complications uterine rupture and placenta praevia have increased in recent years, possibly due to the increase in caesarean section rate [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Surgical complications after caesarean section: A population-based cohort study

et al. 2021

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Background The rate of caesarean section without medical indication is rising but the risk for surgical complications has not been fully explored. Methods Altogether 79 052 women from the Swedish Medical Birth Register who delivered by caesarean section only from 2005 through 2016 were identified and compared with a control group of women delivering vaginally only from the same register and the same period of time. By cross-linking data with the National Patient Register the risks for bowel obstruction, incisional hernia and abdominal pain were analysed, as well as risk factors for these complications. We also analysed acute complications, uterine rupture, and placenta praevia. Findings Caesarean section is associated with an increased risk for bowel obstruction (OR 2.92; CI 2.55–3.34), surgery for bowel obstruction (OR 2.12; CI 1.70–2.65), incisional hernia (OR 2.71; CI 2.46–3.00), surgery for incisional hernia (OR 3.35; CI 2.68–4.18), and abdominal pain (OR 1.41; CI 1.38–1.44). Smoking, obesity, and more than one section delivery added significantly to the risk for these complications. Interpretation Caesarean section is considered a safe procedure, but awareness of the risk for serious complications is important when deciding on mode of delivery. In this study, more than one section, obesity and smoking significantly increased the risk for complications after caesarean section. Prevention of smoking and obesity among fertile women worldwide must continue to be a high priority.

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“…Incisional hernias are abnormal abdominal wall gaps located at post-operative scars, perceptible or palpable by clinical examination or imaging [1]. Incisional hernia is a well-known complication of abdominal surgery [2][3][4]. Incisional hernias result from the weakening of abdominal fascial covering [5].…”

Section: Introductionmentioning

confidence: 99%

“…Incisional hernias result from the weakening of abdominal fascial covering [5]. Generally, incisional hernias result from failure of proper wound healing, which may result from obesity, wound infections, midline incisions, anaemia, poor nutritional status, and smoking [3,6,7].…”

Section: Introductionmentioning

confidence: 99%

Incisional Hernia Following Laparotomy among Women in Enugu, Nigeria: A Ten-year Review

Enebe¹

2022

TIJPH

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An incisional hernia may occur in women following laparotomy. Obesity has become an increasing non-communicable public health problem in middle and low-income countries. Also, the caesarean section has been on the increase even among obese women. The study aimed to evaluate the outcome of care and determine the association between caesarean section and obesity in the development of incisional hernias among women who underwent laparotomy for various indications in Enugu, Nigeria. A retrospective study of women who underwent incisional hernia repair between January 2010 and December 2020 at the 2 tertiary hospitals in Enugu, Nigeria, was carried out. The following parameters were assessed; age, predisposing factors, presence and absence of obesity and the class of obesity, comorbidity, presenting symptoms, duration of symptoms before presentation, the interval between presentation and intervention, intra-operative finding, the definitive operative procedure performed, complications of treatment, and outcome of treatment. A total of 46 patients were evaluated. Their mean age was 44 years. Caesarean section and obesity were the most frequently performed laparotomy (31/46, 67.5%) and most common comorbidity (41/46, 89.2%) respectively among the participants. The majority of the patients (44/46, 95.7%) had mesh repair of the incisional hernia, and most had no post-operative complications. There was no significant relationship between incisional hernia and obesity, p = 0.446. There was no mortality. In conclusion, caesarean section, a frequently performed laparotomy, and obesity as comorbidity were frequently associated with the occurrence of incisional hernia among the participants. The use of appropriate mesh and techniques were associated with good results and reduced recurrence.

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Incisional hernia after cesarean section: A systematic review

Cited by 19 publications

References 26 publications

The risk factors and care measures of surgical site infection after cesarean section in China: a retrospective analysis

The risk factors and care measures of surgical site infection after cesarean section in China: a retrospective analysis

Surgical complications after caesarean section: A population-based cohort study

Incisional Hernia Following Laparotomy among Women in Enugu, Nigeria: A Ten-year Review

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