Wasfi M Salayta, Hasan Al Dahamsheh.
Incisional hernia after elective midline caesarean section: incidence and risk factors.
Rawal Med J Jan ;36(3):214-7.

Objective: To analyze the incidence and risk factors for hernia after elective lower midline caesarean section (CS). Patients and Methods: 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 and December 2008. All had history of at least 2 previous CSs. Patients were distributed in two groups; study group consisted of women who had incisional hernia and control group who had no hernia within 2-years after operation. 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 for the development of incisional hernia. Results: 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. Conclusions: We conclude 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 infection may reduce the incidence of incisional hernia following elective midline cesarean section.

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