Dumont M
Clinique Gynécologique et Obstétricale à la Faculté de Médicine, Lyon, Caluire.
J Gynecol Obstet Biol Reprod (Paris). 1990;19(4):395-9.
Congenital or traumatic hernia complicating pregnancy is a rarity but death occurs in half of the cases. Complications (respiratory distress, intestinal obstruction) are more frequent during the third trimester, during delivery and in the post-partum hours. In the asymptomatic patient, surgery should be performed specially in the first and second trimesters. During the third trimester, fetal maturity should be watched and the defect should be repaired at the time of elective cesarean section. Active labor should be avoided because of the increased abdominal pressure produced during the expulsion period. If an unexpected labor occurs, forceps application, if cesarean section could not be performed, should be realised. If signs of respiratory distress or of obstruction arise at any time, immediate repair should be undertaken, regardless of the age of pregnancy. An hernia operated before the pregnancy could recur during this one (this is the case of the author). Il is possible that some diaphragmatic hernias no complicated during previous pregnancies could be aggravated without symptoms and are complicated during a further pregnancy.
先天性或外伤性疝合并妊娠很罕见，但半数病例会死亡。并发症（呼吸窘迫、肠梗阻）在妊娠晚期、分娩期间及产后数小时更为常见。对于无症状患者，尤其是在妊娠早期和中期应进行手术。在妊娠晚期，应监测胎儿成熟度，并在择期剖宫产时修复缺损。由于分娩期腹压增加，应避免活跃分娩。如果发生意外分娩，若无法进行剖宫产，应使用产钳助产。如果在任何时候出现呼吸窘迫或梗阻迹象，无论妊娠周数如何，都应立即进行修复。妊娠前接受过手术的疝在此期间可能复发（作者就遇到过这种情况）。先前妊娠期间未出现并发症的一些膈疝有可能在无任何症状的情况下病情加重，并在再次妊娠期间出现并发症。
