scholarly journals Letter to the editor: An ultrasound observation study on the levator hiatus with or without diastasis recti abdominis in postpartum women?

Author(s):  
I-Chieh Sung ◽  
Ching-Ju Shen ◽  
Cheng-Yu Long
Author(s):  
Peng Tian ◽  
Dong Mei Liu ◽  
Chao Wang ◽  
Yu Gu ◽  
Guo Qing Du ◽  
...  

Abstract Introduction and hypothesis 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 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. Methods One 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. Results DRA 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. Conclusions DRA 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.


Author(s):  
Won Ha ◽  
Sin Young Song ◽  
Chi Sun Yoon ◽  
Kyu Nam Kim

Abstract Diastasis recti abdominis is a condition defined as the separation between the rectus abdominis and the linea alba, which leads to weakness in the abdominal muscles. Diastasis may be slight or severe, sometimes resulting in herniation of the abdominal viscera. Following childbirth, most women develop some extent of muscle separation in the postpartum period. However, if the diastasis recti abdominis in the postpartum period remain severe, it should be corrected to prevent concurrent abdominal hernia, strangulation or incarceration. We herein present two Korean cases of postpartum women with severe diastasis recti abdominis with abdominal hernia; it is the first report of its kind from Korea. Two women were referred to our clinic with severe abdominal bulge. Computerized tomography scan showed widening of the linea alba with abdominal hernia. The standard abdominoplasty with multiple wide longitudinal plications of the abdominal wall was performed in each patient under general anesthesia. There was no recurrence of diastasis recti abdominis or abdominal hernia during follow-up periods. The application of abdominoplasty in postpartum women with severe diastasis recti abdominis with abdominal hernia is thus considered to be an efficient management option. We hope these cases can provide a reference for the treatment of similar situations.


2015 ◽  
Vol 11 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Patricia Mota ◽  
Augusto Gil Pascoal ◽  
Kari Bo

Diastasis recti abdominis (DRA) or the increased inter rectus distance (IRD) is described as the separation of the rectus abdominis muscles. It can occur during pregnancy and after childbirth. Mota et al. (2015) found DRA may affect up 100% of pregnant women [1], and it may persist separated in the immediate postpartum period in 35% to 60% of women [2]. Reported prevalence of DRA or increased IRD varies and may be inaccurate due to different cut off points for the diagnosis [1-7] and use of different measurement methods. To date limited studies about the normal width of the IRD in postpartum women are available [8, 9], and there is scarce information about risk factors for DRA. There are some theories stating that failure to treat DRA effectively can lead to long term sequelae [10], including abnormal posture [1], lumbo-pelvic pain and cosmetic imperfections [10]. Postnatal women are stimulated to resume abdominal exercises shortly after delivery [3] to improve trunk function and restore abdominal figure and fitness [8]. To date there is scant knowledge on the most effective abdominal exercises both during pregnancy and after childbirth. In particular there is little evidence on which exercises are most efficient in the narrowing of the recti diastasis. The aim of this article is to critically review the literature on the risk factors, functional implications and the effect of exercise on DRA. This information is expected to be relevant for physiotherapists and exercise professionals.


2017 ◽  
Vol 6 (1) ◽  
pp. 15-20
Author(s):  
Fatima Bichi ◽  
Dr. Shumaila Hanif

Diastasis Recti (DR) is a common muscular condition often present during and after pregnancy. This cross-sectional correlational study investigated the prevalence of DR among pregnant and postpartum women. A total of 250 pregnant and postpartum women were recruited using convenience sampling technique from obstetrics and gynaecology department, Aminu Kano Teaching Hospital, Kano, Nigeria. Age, body mass, height, BMI, parity, trimester, duration of DR postpartum, location of DR and DR status was recorded for each participant. Presence of DR was confirmed using the finger width method. Descriptive statistics of mean, SD, percentage were used to describe the data and determine the prevalence. Inferential statistics of Pearson’s and Spearman’s correlation were used to analyse the relationship between prevalence of DR and age, parity and duration of DR postpartum. Chi square was computed to determine the difference in prevalence of DR across trimesters. The result of this study indicated high prevalence of DR in post-partum and pregnant women (84% and 64.7% respectively); the most common location of DR was at the umbilicus in both pregnant and postpartum women. Prevalence of DR was high among the multigravida; and a significant relationship was found between prevalence of DR and age and parity of participants. There was a significant difference in prevalence of DR across the trimesters. It can be concluded that prevalence of DR among pregnant and postpartum women is high; age and parity are determinants of DR prevalence. Evaluation of DR should be considered as routine assessment in both pregnant and postpartum women.


2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Anders Olsson ◽  
Katarina Woxnerud ◽  
Gabriel Sandblom ◽  
Otto Stackelberg

Abstract Aim Management of diastasis recti abdominis (DRA) differs regarding core training, surgical repair methods and post-operative rehabilitation. The purpose of this prospective cohort study was to evaluate the effect of a novel concept of treatment for DRA, the TOR-concept (Training, Operation and Rehabilitation). The concept includes preoperative evaluation of symptoms and instructed abdominal core training; tailored surgical repair of the DRA; and an individualized postoperative rehabilitation program. Material and Methods A cohort of seventy-five post-partum women with diagnosed DRA and training resistant core dysfunctions were evaluated and included to the study during 2018-2020. After surgery, all participants underwent an individualized supervised rehabilitation program with progressive increasing load for four months. Physical function was registered preoperatively and one year after surgery with the disability rating index (DRI) questionnaire. Quality of life (QoL) was assessed with the SF-36 questionnaire. The DRA and the surgical result were assessed with ultrasonography before and one year after surgery. Results Sixty-nine participants, 92%, completed the study. There were no DRA-recurrences at the 1-year follow-up. Early results shows that self-reported physical function, (DRI), improved in 88.8 % of patients, with a mean score improvement of 78.5 %. Quality of life, (SF-36), improved significantly compared with the preoperative scores, and reached a level similar to, or higher than, the normative Swedish female population. Conclusions In this cohort of post-partum women with DRA combined with core instability symptoms resistant to training, surgical reconstruction within the TOR-concept resulted in a significant improvement of physical function and QoL.


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