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

AimsCompare 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. MethodsThis 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 4.5cm above, at, or 4.5cm below the umbilicus. ResultsAt gestational week 21 women with diastasis recti abdominis had statistically significant greater VRP (mean difference 3.06cm H2O [95%CI: 0.70; 5.42]), PFM strength (mean difference 5.09cm H2O [95%CI: 0.76; 9.42]) and PFM muscle endurance (mean difference 47.08cmH(2)Osec [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). ConclusionsWomen with diastasis were not more likely to have weaker PFM or more UI or POP. Neurourol. Urodynam. 36:716-721, 2017. (c) 2016 Wiley Periodicals, Inc.