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Ginecología y obstetricia de México

versão impressa ISSN 0300-9041

Resumo

HERNANDEZ-RODRIGUEZ, Rodolfo et al. Umbilical gravid hysterocele. A case report. Ginecol. obstet. Méx. [online]. 2019, vol.87, n.5, pp.341-345.  Epub 30-Jun-2021. ISSN 0300-9041.  https://doi.org/10.24245/gom.v87i5.2920.

BACKGROUND:

Although umbilical hernia is relatively common in African patients, the majority of cases are asymptomatic. The situation in which a gravid uterus enters a hernia sac is one of the rarest complications of umbilical hernia.

CLINICAL CASE:

30-year-old pregnant woman with a history of umbilical hernia and obstetric of 5 pregnancies, 4 deliveries and 1 spontaneous abortion. She reported pain in the abdomen that appeared 3 days ago, absence of menstruation 5 months ago, with fetal movements referred 2 weeks ago and absence of them 3 days ago. At the physical examination, an irreducible volume increase of approximately 30 cm in diameter with a pendulum shape that protruded through a large umbilical hernia ring and reached the middle of the thighs, fetal parts were palpated and absence of fetal heartbeats. Due to the antecedents, the clinic and the obstetric ultrasound, an intrauterine fetal death was diagnosed as a complication of a gravid uterus in an umbilical hernia. The interruption of pregnancy was performed by emergency caesarean section. The umbilical hernia was repaired with reinforcement of the defect using fascio-aponeurotic flaps, according to the Mayo technique. The evolution was satisfactory until hospital discharge.

CONCLUSIONS:

The treatment of pregnant patients with umbilical hernia includes a conservative behavior, strict prenatal control, placement of a brace to rectify the pregnant uterus, programming of the cesarean and repair of the hernia defect.

Palavras-chave : Umbilical hernia; Pregnant uterus; Fetal death.

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