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

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.

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.

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).

Women with diastasis were not more likely to have weaker PFM or more UI or POP. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.

Neurourology and urodynamics. 2016 Mar 31 [Epub ahead of print]

Kari Bø, Gunvor Hilde, Merete Kolberg Tennfjord, Jorun Bakken Sperstad, Marie Ellstrøm Engh

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