Ventral hernia containing a term gravid uterus: A rare challenge in surgical and obstetric management

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A 28-year-old woman at 34.5 weeks of gestation presented with an incarcerated ventral hernia containing the gravid uterus and overlying skin ulceration, one year after a cesarean section. Magnetic resonance imaging revealed a large infraumbilical defect with herniation of the uterus and small bowel. Given the risk of rupture and infection, an urgent cesarean delivery followed by primary abdominal wall repair without mesh was performed. Both maternal and neonatal outcomes were favorable. Gravid uterine herniation through an incisional defect is extremely rare and requires individualized multidisciplinary management, with primary repair being a safe option in contaminated or high-risk settings.