Effects of different delivery modes on diastasis recti abdominis in early postpartum period

Objective To evaluate the effects of different delivery modes on diastasis recti abdominis （DRA） in 6-8 weeks postpartum period. Methods Clinical data of 1354 singleton deliveries who had regular prenatal examination and delivery were collected. According to delivery times and delivery modes, 775 primiparous women [including 546 vaginal delivery （A1 group） and 229 caesarean section （B1 group）] and 579 multipara women [including 357 second vaginal delivery （A2 group） and 222 second caesarean section （B2 group）] were followed-up. The inter-rectus distance was examined by high-frequency ultrasound at three locations on the linea alba （3 cm above the umbilicus, umbilicus, 3 cm below the umbilicus） in 6-8 weeks postpartum. The effects of two delivery modes on DRA in postpartum period were evaluated. Results DRA mainly occurred at umbilicus, followed by at the 3 cm above the umbilicus and 3 cm below the umbilicus. The incidence of DRA in the caesarean section groups was higher than that of the vaginal delivery groups among primiparous or multipara women （92.1% vs. 77.6% and 95.5% vs. 90.8%, both P < 0.05）. The inter-rectus distance at three locations in the caesarean section groups was longer than that in the vaginal delivery groups among primiparous or multipara women （B1 group vs. A1 group and B2 group vs. A2 group, all P < 0.001）. The inter-rectum distance at three locations in B2 group was longer than that in B1 group （all P < 0.001）. Conclusion Caesarean section elevates the incidence of DRA and increases the inter-rectus distance in early postpartum period.