Differences in Inter-Rectus Distance and Abdominopelvic Function between Nulliparous, Primiparous and Multiparous Women.

Mercè Balasch-Bernat,Juan J Carrasco,Lirios Dueñas,Begoña Valls-Donderis,Laura Fuentes-Aparicio,Sofía Pérez-Alenda

doi:10.3390/ijerph182312396

Mercè Balasch-Bernat, Juan J Carrasco + Show 4 more

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https://doi.org/10.3390/ijerph182312396

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Abstract

Widening of the inter-rectus distance (IRD) is highly prevalent among postpartum women and can lead to dysfunction of abdominopelvic muscles. The aim of this study was to evaluate the differences in IRD and abdominopelvic function between nulliparous, primiparous and multiparous women. A cross-sectional study was conducted on 75 women (25 nulliparous, 25 primiparous and 25 multiparous at 6 months postpartum). The participants underwent ultrasound assessment under three conditions (at rest, abdominal draw-in maneuver (ADIM) and curl-up) at two locations (2 cm above and 2 cm below the umbilicus). Furthermore, abdominopelvic muscle function was determined by prone, supine and side bridge tests. In all conditions and locations, the IRD were significantly higher (p < 0.05) in the primiparous and multiparous women than in the nulliparous. The multiparous women presented greater (p > 0.05) IRD at rest and during ADIM compared to the primiparous women. Regarding abdominopelvic muscle function, differences were only significant (p < 0.05) between the nulliparous with primiparous women in prone and supine conditions. These findings suggest that parity influences IRD: women at 6 months postpartum present greater IRD compared to nulliparous women; multiparous women present greater IRD at rest and during the activation of deep abdominal muscles than primiparous women; and primiparous women exhibit worse abdominopelvic muscle function than nulliparous women.

Highlights

Inter-rectus distance (IRD) refers to the separation between the two bellies of the rectus abdominis muscle along the linea alba [1,2]
The abnormal widening of the IRD is known as diastasis of the rectus abdominis (DRA)
Parity influences IRD at 6 months postpartum, as both primiparous and multiparous women present greater IRD at rest as well as during the activation of the abdominal muscles compared to nulliparous women

Summary

Introduction

Inter-rectus distance (IRD) refers to the separation between the two bellies of the rectus abdominis muscle along the linea alba [1,2]. The abnormal widening of the IRD is known as diastasis of the rectus abdominis (DRA) This condition can occur in both men and women; it is more prevalent in pregnant women during the third trimester as well as in postpartum [1,3]. Hormonal influence on the connective tissue increases this elongation [6] This can lead to the dysfunction of the abdominopelvic muscles, including the rectus abdominis, the external and internal obliques, and the transversus abdominis [7]. These changes tend to decrease throughout the postpartum, several studies have shown that DRA can remain even until 6 months and 1 year postpartum [4,8]

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