An interesting “Ask your doctor” question and answers:

Client’s Question:
I had a massive ventral hernia and divarication of rectii after my caesarean in the year 2000. I had my hernia repaired and a 10*14 inches prolene meshrepair done on 1/6/2004. I have not had any problem as of now. In the month of Jan 2008 i did not get my periods. Two days before i had an ultrasound done and the doctor says i am 16 weeks pregnant. The most suprising thing is i did not have any pregnancy symptoms and had normal periods till December 2007. The doctor says i have conceived on 22nd October 2007 and my due date is on July 28th. My question to you is:-

1. Can i continue with this pregnancy as i have been operated once for my C-section and second for ny ventral hernia?
2. As the mesh is there inside will it be affected by the growth of the baby?
3. As the pregnancy progresses what are the problems i can face in my abdominal region?
4. If i have to undergo one more caesarean section can it affect the mesh or can i be able to withstand it?
5. If i continue with this pregnancy wil it become life- threatening in the end?

Answer sent :
Thanx for enquiry.
Pregnancy, another Caesarian and preferably at the same time as Caesasrian, if possible (general health condition permitting), Hernia repair also is a good option.

1. U can continue with pregnancy - it is quite safe.
2. Mesh will continue to be there, but somewhere it mat give way - hernia would recur. But it can be retackled .
3. No particular problem except that hernia will most probably recur.
4. At the next Caesarian, if U R healthy U can withstand Caesarian + Hernia repair too unless something unforseen happens and if that be the case, U may have to plan for Hernia repair at another sitting.
5. Very very unlikely to be "life threatening" if U continue with pregnancy.

U may read a detailed Newsletter on this kind of Hernias in our site called "other Hernias" on page "Our Strength".

U R lucky, if your "massive" incisional hernia repair is still holding. Because, by whatever technique of repair by however great expert Surgeon, these Hernias can still recur!! Hence at the next caesarian and the hernia repair too u need to be lucky again to have a successful hernia repair.

Please do feel free to seek any further info/advice. Let me include U in our subscriber list. Best wishes,
Dr. M.Mohan Rao,

Acknowledgement by Client:
Thank you for the reply and the details thereof.

I guess you remember my operation in 2003 for the Hernia. It was just that it still worries us since the mesh is inside and chances of hernia re occuring as you have mentioned is high.