الفتق بعد الولادة: نصلّحه دلوقتي ولا نستنى؟ | Hernia After Pregnancy: Repair Now or Wait?
الانفصال العضلي بعد الولادة | Rectus Diastasis After Pregnancy
الفتق الصغير بعد الولادة (Postpartum hernia) غالبًا سببه الانفصال العضلي (Rectus diastasis) مع تكرار الحمل والسمنة. د. محمد حسام زيدان بيشرح إن الانفصال بين عضلتي البطن بيحصل طبيعي في الحمل وبيرجع خلال حوالي سنة ونص، لكن لو حصل حمل تاني قبل كده بيستمر وممكن يعمل فتق. وبينصح إن إصلاح الفتق أو الانفصال العضلي يتعمل بعد سنة ونص على الأقل من آخر ولادة، وإن المريضة ما تخططش لحمل لمدة سنة ونص بعد العملية، لأن الحمل المبكر بيزوّد فرصة رجوع الفتق. | A small hernia after childbirth is often caused by rectus diastasis, the separation of the abdominal muscles, together with repeated pregnancies and excess weight. Dr. Mohamed H. Zidan explains that the muscles normally separate during pregnancy and come back together within about 18 months, but another pregnancy before then keeps them apart and can lead to a hernia. He advises repairing the hernia or diastasis at least 18 months after the last delivery, and avoiding pregnancy for 18 months after surgery, because an early pregnancy raises the risk of recurrence.
Key Takeaways
Full Transcript
Peace be upon you. Many women come to us right after childbirth with a small hernia. What causes a small hernia after childbirth? It is caused by repeated pregnancies, together with excess weight and weakness of the abdominal wall. Where does this weakness come from? It comes from separation of the abdominal muscles, which happens with repeated pregnancies less than a year and a half apart. Normally, the two muscles of the abdominal wall separate during pregnancy, and they come back together within about a year and a half. If another pregnancy or birth happens before that, the separation persists, and that persistent separation leads to a hernia in the abdominal wall. So when should we repair a hernia or muscle separation after childbirth? It's best to repair it a year and a half after delivery, provided the patient doesn't plan another pregnancy for a year and a half after the operation. If we operate and a pregnancy occurs within that year and a half, the hernia recurrence rate rises by 60%, so it's best to wait a year and a half after the last delivery before surgery.