The precise incidence of incisional hernia after midline cesarean section is unknown.
The aim of this study was to analyze the incidence and risk factors for hernia after
elective lower midline caesarean section (CS). A prospective cohort study of 284 women
for incisional hernia development after elective midline CS) was conducted at Prince
Hashem Ben Al-Hussein hospital from April 2006 to December 2008. All patients included
had a history of at least two previous CSs. Patients were divided in two groups: one
study group consisted of women who had an incisional hernia and the control group
consisted of women who had not developed an incisional hernia within two years post
CS. Within the two groups, potential risk factors (age, body mass index, parity, number
of previous cesareans, type of previous incision, chronic cough, diabetes mellitus,
heart disease, low albumin, anesthesia type, postoperative fever and wound complications)
were statistically analyzed with the development of incisional hernia. The two year
hernia frequency was 5.6% .Independent risk factors of incisional hernia development
included: increase in number of previous CSs, obesity, and wound complications. We
concluded that this incidence was higher than previously estimated. Counseling on
the family size for this group of women will reduce the chance for further CS with
its associated risk. In addition, measures to reduce wound infections may reduce the
incidence of incisional hernia following elective midline cesarean section.
Key-words:
Women - Cesarean section - hernia - wound - complications
