Umbilical hernias are bulges at the belly button caused when the lining of the abdomen or abdominal organs push through a weakened area at the navel. Most umbilical hernias are present at birth and only become a problem during pregnancy, when the weight of the developing baby causes the hernia to worsen and begin to hurt. In most cases, an umbilical hernia in pregnancy is treated with a pregnancy support belt, which is used to transfer some of the weight from the abdomen to the back. When abdominal tissue or organs become trapped, or incarcerated, in the hernia, which prevents blood flow to the trapped tissue and eventual tissue death, the hernia needs to be treated immediately. The treatment for an incarcerated umbilical hernia is surgery to remove the trapped tissue and repair the hernia.
An umbilical hernia is typically diagnosed by symptoms and a physical exam, and it will be periodically reviewed throughout the pregnancy using ultrasound surveys to watch and see if it becomes incarcerated. A painful hernia that is not incarcerated is treated with a pregnancy support belt. Using the support belt to transfer some of the baby’s weight from the stomach to the back will often alleviate the pain.
Symptoms of an incarcerated umbilical hernia are nausea and vomiting, abdominal pain and swelling, weakness, and dizziness. In order to prevent tissue death and infection, immediate treatment is necessary. It can be repaired by removing the incarcerated tissue and then stitching the weakened area securely closed or by placing a piece of mesh over the opening for reinforcement, and stitching the mesh to the abdominal wall. If the baby is close to term, one option is to perform a cesarean section to safely deliver the baby, and then repair the umbilical hernia at the same time. The surgery can be performed mid-pregnancy is the baby is not close enough to full-term to perform a c-section.
The risks for surgical repair of an umbilical hernia in pregnancy are slightly greater than in other situations, including anesthesia complications and infection. This surgery typically lasts about two hours and, if the pregnancy is healthy, is often done on an out-patient basis. Most women need to take it easy for two to four weeks following the surgery, and some are advised to wear a pregnancy support belt while healing or for the remainder of the pregnancy.