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Neurourol Urodyn. 2017 Mar;36(3):716-721. doi: 10.1002/nau.23005. Epub 2016 Mar 31.

Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study.

Author information

1
Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
2
Department of Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway.
3
Faculty of Medicine, University of Oslo, and Akershus University Hospital, Oslo, Norway.

Abstract

AIMS:

Compare vaginal resting pressure (VRP), pelvic floor muscle (PFM) strength, and endurance in women with and without diastasis recti abdominis at gestational week 21 and at 6 weeks, 6 months, and 12 months postpartum. Furthermore, to compare prevalence of urinary incontinence (UI) and pelvic organ prolapse (POP) in the two groups at the same assessment points.

METHODS:

This is a prospective cohort study following 300 nulliparous pregnant women giving birth at a public university hospital. VRP, PFM strength, and endurance were measured with vaginal manometry. ICIQ-UI-SF questionnaire and POP-Q were used to assess UI and POP. Diastasis recti abdominis was diagnosed with palpation of  ≥2 fingerbreadths 4.5 cm above, at, or 4.5 cm below the umbilicus.

RESULTS:

At gestational week 21 women with diastasis recti abdominis had statistically significant greater VRP (mean difference 3.06 cm H2 O [95%CI: 0.70; 5.42]), PFM strength (mean difference 5.09 cm H2 O [95%CI: 0.76; 9.42]) and PFM muscle endurance (mean difference 47.08 cm H2 O sec [95%CI: 15.18; 78.99]) than women with no diastasis. There were no statistically significant differences between women with and without diastasis in any PFM variables at 6 weeks, 6 months, and 12 months postpartum. No significant difference was found in prevalence of UI in women with and without diastasis at any assessment points. Six weeks postpartum 15.9% of women without diastasis had POP versus 4.1% in the group with diastasis (P = 0.001).

CONCLUSIONS:

Women with diastasis were not more likely to have weaker PFM or more UI or POP. Neurourol. Urodynam. 36:716-721, 2017. © 2016 Wiley Periodicals, Inc.

KEYWORDS:

diastasis recti abdominis; pelvic floor muscles; pelvic organ prolapse; postpartum; pregnancy; urinary incontinence

PMID:
27037746
DOI:
10.1002/nau.23005
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