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Updated: Jul 4, 2025

Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
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Association Between Inter-Recti Distance and Impaired Abdominal Core Function in Post-Partum Women With Diastasis

L Bixo1, G Sandblom2,3, J Österberg1,4

  • 1Department of Surgery, Mora Hospital, Mora, Sweden.

Journal of Abdominal Wall Surgery : JAWS
|February 5, 2024
PubMed

Background and Aim: The definition and management of Diastasis Recti Abdominis (DRA) is under debate. This study aimed to understand the correlation between the post-partum inter-recti distance (IRD) and functional impairments associated with core instability, with the hypothesis that IRD could serve as a proxy for core instability symptoms and constitute a tool in decision-making for DRA treatment. Material and Methods: A cohort of post-partum women with abdominal core instability symptoms combined with DRA were studied. The size of IRD was measured with ultrasonography and cross-sectionally analysed against functional impairments registered with the self-report Disability Rating Index (DRI), which grades the ability to perform 12 different daily activities. Results: A total of 224 women were included in the study. In univariable analysis, IRD was associated with impairment of the activities running (p = 0.007), heavy work (p = 0.036) and exercise/sports (p = 0.047), but not with dressing, walking, sitting for long periods, standing bent over a sink, carrying a suitcase, making a bed, light manual labour or heavy lifting. No significant correlations were seen in the multivariable analysis when adjustments were made for BMI and parity. Conclusion: IRD and post-partum functional impairments had no significant correlation in multivariable analysis. The post-partum core instability condition is complex and probably associated with more factors than solely the IRD. The IRD alone does not seem to be a sufficient proxy for decision-making regarding optimal treatment. A more complete instrument to assess the post-partum abdominal core is warranted.

Keywords:
diastasis recti abdominisdisability rating indexinter-recti distancepost-partumrectus diastasis

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