Abstract

Introduction and hypothesisWe hypothesized that differences in post-partum levator hiatus (LH) measurements, as well as the area of urethra and bladder (AUB), viewed under ultrasound, correlate with diastasis rectus abdominis (DRA) occurrence. The primary objective of this study is to determine ultrasound parameters available for diagnosing DRA in post-partum women. We compared LH and AUB measurements under ultrasound in primiparous women, with and without DRA, at 24–26 weeks postpartum.MethodsOne hundred ninety-four women underwent routine examination, including a self-made clinical symptoms questionnaire, DRA evaluation, and LH and AUB measurements. Independent samples t- and chi-squared tests were used to compare the differences between women with and without DRA.ResultsDRA incidence was significantly higher among those who underwent cesarean section (CS) than for vaginal delivery (VD) (P = 0.038). DRA patients could potentially have urinary urgency, frequency, pain, dysuria, and perineal tears. Additionally, statistically significant differences were found between VD patients, with or without DRA, in the resting LH transverse diameter (TrD) (P = 0.032) and the area of the levator hiatus (ALH) (P = 0.048) as well as AUB at Valsalva (P = 0.049). No differences, however, were found between the DRA and no DRA groups for all those measurements among women who had cesarean deliveries.ConclusionsDRA was more likely in post-CS women. Furthermore, the results showed a plausible association between DRA occurrence and LH expansion, especially in women with VD under rest and Valsalva. This could be useful for developing therapeutic plans based on these parameters for post-partum rehabilitation of women with DRA to avoid long-term complications.

Highlights

  • Introduction and hypothesisWe hypothesized that differences in post-partum levator hiatus (LH) measurements, as well as the area of urethra and bladder (AUB), viewed under ultrasound, correlate with diastasis rectus abdominis (DRA) occurrence

  • Using our simple self-made questionnaire, we found that a significant difference was present with respect to the occurrence of perineal tear between the DRA and no-DRA groups, where it was more common in the former (P = 0.005; Table 2)

  • The difference with respect to perineal tear was still present even when delivery mode was taken into account, where it was more prevalent among group II (VD with DRA) than group I (VD, no DRA) (P = 0.000)

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Summary

Introduction

We hypothesized that differences in post-partum levator hiatus (LH) measurements, as well as the area of urethra and bladder (AUB), viewed under ultrasound, correlate with diastasis rectus abdominis (DRA) occurrence. The results showed a plausible association between DRA occurrence and LH expansion, especially in women with VD under rest and Valsalva. This could be useful for developing therapeutic plans based on these parameters for post-partum rehabilitation of women with DRA to avoid long-term complications. Int Urogynecol J (2021) 32:1839–1846 likely to have weaker pelvic floor muscle strength (PFMS), UI, or POP This finding is confirmed by research showing similar results in women at 6–8 weeks postpartum [3]. Due to the contradictions in current studies regarding the relation of DRA, PFD, and related symptoms, we explored whether DRA was associated with LH to clarify the relationship between intra-abdominal and pelvic pressures

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