腹直肌分离对初产妇第二产程时长及产后生活质量的影响

Effects of diastasis recti abdominis on duration of second stage of labor and postpartum quality of life in primiparae

目的探讨腹直肌分离(DRA)对初产妇第二产程时长及产后生活质量的影响。方法将产后6~8周的足月顺产初产妇240例,根据腹直肌有无分离分为无DRA组(腹直肌间距≤2 cm)和DRA组(腹直肌间距>2 cm),每组120例,分析分娩时腹直肌间距与第二产程时长的相关性,比较两组产妇产后起床困难、腰背痛、便秘发生率、对腹型的满意度及Ⅰ类肌和Ⅱ类肌肌力严重受损、尿失禁、盆腔器官脱垂发生率。结果分娩时腹直肌间距与第二产程时长之间无相关性(P>0.05)。DRA组产后起床困难发生率高于无DRA组(P<0.05),但两组的腰背痛和便秘发生率、腹型满意度、Ⅰ类肌和Ⅱ类肌肌力严重受损、尿失禁、盆腔器官脱垂发生率比较,差异均无统计学意义(均P>0.05)。结论对于初产妇,DRA会增加产后起床困难的发生率,但可能与第二产程时长、产后腰背痛和便秘的发生、腹型满意度及尿失禁、盆腔器官脱垂的发生均无关。

Objective To explore the effects of diastasis recti abdominis(DRA)on the duration of the second stage of labor and postpartum quality of life in primiparae.Methods A total of 240 primiparae 6 to 8 weeks after full-term normal delivery were divided into non-DRA group(with rectus abdominis spacing no more than 2 cm)and DRA group(with rectus abdominis spacing more than 2 cm)according to the presence of DRA,with 120 cases in each group.The correlation between rectus abdominis spacing at delivery and the duration of the second stage of labor was analyzed,and the two groups were compared in terms of the postpartum incidence rates of difficulty in getting out of bed,low back pain,and defecation,satisfaction with postpartum abdomen shape,and the postpartum incidence rates of typesⅠandⅡmuscle strength damage,urinary incontinence,and pelvic organ prolapse.Results No correlation was found between rectus abdominis spacing at delivery and the duration of the second stage of labor(P>0.05).The DRA group has a higher incidence rate of difficulty in getting out of bed after delivery than the non-DRA group(P<0.05),whereas there was no statistically significant difference between the two groups in the incidence rate of lower back pain or constipation,satisfaction with abdomen shape,or incidence rate of typeⅠorⅡmuscle strength damage,urinary incontinence,or pelvic organ prolapse(all P>0.05).Conclusion For primiparae,DRA might increase the incidence rate of postpartum difficulty in getting out of bed,but might not correlate with the duration of the second stage of labor,the postpartum incidence of low back pain or constipation,satisfaction with abdomen shape,or the incidence of urinary incontinence or pelvic organ prolapse.