Early postpartum unilateral vulvar edema leading to diagnosis of a Pfannenstiel incisional hernia following cesarean delivery

Abstract

Advantages of the low transverse Pfannenstiel incision include lower rates of incisional hernia, wound infection, hematoma formation, direct postoperative pain and distinctly improved aesthetic appearance. Relative disadvantages include insufficient intraoperative exposure of the upper abdomen and an increased incidence of superficial nerve entrapment. Incisional hernia following Pfannenstiel incision is a rare event with a reported incidence of between 0 and 0.5% while in contrast midline vertical incisions are considerably more common with a reported incidence of 5 to 30%. Symptomatology of Pfannenstiel incisional hernia has been reported to include: bulging, pain or discomfort, and distention of the surgical area. We report an unusual case of early postpartum unilateral vulvar edema, which led to imaging diagnosis of Pfannenstiel incisional hernia in a 41 year-old woman on Day 2 following Cesarean delivery due to preeclampsia with worsening severe features, at 30 weeks’ gestation.