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Pelvic floor muscle function, pelvic floor dysfunction and diastasis recti abdominis: Prospective cohort study
Author(s) -
Bø Kari,
Hilde Gunvor,
Tennfjord Merete Kolberg,
Sperstad Jorun Bakken,
Engh Marie Ellstrøm
Publication year - 2017
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23005
Subject(s) - medicine , diastasis , pelvic floor , prospective cohort study , pelvic floor muscle , obstetrics , surgery
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 H 2 O [95%CI: 0.70; 5.42]), PFM strength (mean difference 5.09 cm H 2 O [95%CI: 0.76; 9.42]) and PFM muscle endurance (mean difference 47.08 cm H 2 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.