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Rectus muscle reapproximation at cesarean delivery: a randomized controlled trial
Berna Aslan Cetin1, Fitnat Topbas2, Kübra Keskin Toptas1
1Başakşehir Cam and Sakura City Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.
Summary
Suturing the rectus muscles during cesarean delivery (CD) reduced rectus diastasis below the umbilicus at six weeks postpartum. However, this surgical technique did not impact postoperative pain scores.
Area of Science:
- Obstetrics and Gynecology
- Surgical Innovation
- Postpartum Recovery
Background:
- Cesarean delivery (CD) is a common surgical procedure.
- Rectus muscle diastasis is a frequent complication following CD.
- Current surgical techniques for CD vary, impacting postpartum outcomes.
Purpose of the Study:
- To evaluate the impact of rectus muscle reapproximation during CD on postoperative pain.
- To assess the effect of rectus muscle reapproximation on rectus diastasis at six weeks postpartum.
Main Methods:
- Prospective, randomized study involving 296 women undergoing primary CD.
- Participants were assigned to either rectus muscle reapproximation or a control group.
- Postoperative pain (Visual Analogue Scale) and inter-rectus distance (IRD) were measured at 1 day and 6 weeks.
Main Results:
- No significant difference in Visual Analogue Scale (VAS) scores or need for analgesia between groups.
- Significantly shorter inter-rectus distance (IRD) below the umbilicus at 6 weeks in the rectus muscle reapproximation group.
- Logistic regression indicated rectus muscle reapproximation negatively impacts rectus diastasis development below the umbilicus (OR=2.830, p=0.013).
Conclusions:
- Rectus muscle reapproximation during cesarean delivery effectively reduces rectus diastasis below the umbilicus.
- This surgical approach does not influence postoperative pain levels.
