Pelvic organ dysfunction in women with diastasis recti abdominis
DOI:
https://doi.org/10.15574/HW.2024.172.25Keywords:
diastasis recti abdominis, pelvic organ function, pregnancy, determinantsAbstract
Diastasis rectus abdominis (DRM), pelvic organ dysfunction are common pathological conditions after pregnancy. Abdominal muscles are weakened with DRM, which leads to inefficient participation of the anterior abdominal wall in the processes of functioning of the main pelvic organs: bladder and rectum.
Аim - to evaluate the main determinants of the development of DRM and to establish the relationship between the presence of diastasis and disorders of the pelvic organs in women who have given birth.
Materials and methods. We analyzed pelvic organ disorders in 151 patients with diastasis recti abdominis. which were divided into types according to the Nahas classification. Type A diastasis recti abdominis in 21 (13.9%) patients, type B in 81 (53.6%), and types C/D in 49 (32.5%). The endpoint of the study was DRM: significance between its severity and potential pelvic organ disorders was assessed using Fisher's exact test or chi-square test for categorical variables.
Results. The frequency of postpartum disorders depended on the severity of diastasis recti abdominis. In patients with type A, the frequency of pain/discomfort, urinary incontinence, and gas/liquid stool incontinence was 52.4%, 61.9%, and 66.7%, respectively. In patients with severe diastasis recti abdominis, the rates were 81.6%, 75.5%, and 79.6%, respectively. Excess weight and episiotomy during delivery were much stronger determinants than the severity of diastasis recti abdominis. The higher risk of the pelvic organ dysfunction was noted in older patients, active smokers, and those who developed gestational diabetes.
Conclusions. The severity of DRM depends on age, body mass index, number of pregnancies, episiotomy during delivery, smoking, gestational diabetes. There is no strong dependency on delivery by cesarean section or the use of vacuum/forceps, nor on the presence of hypothyroidism in patients.
The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the women was obtained for the research.
The authors declare no conflict of interest.
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