Joueidi Yolaine, Vieillefosse Sarah, Cardaillac Claire, Mortier Anaïs, Oppenheimer Anne, Deffieux Xavier, Thubert Thibault
Service de gynécologie, CHU de Nantes, 38, boulevard Jean Monnet, 44000 Nantes.
Service de gynécologie - Hôpital Antoine-Béclère - AP-HP, 157, Rue de la Porte de Trivaux, 92140 Clamart.
Prog Urol. 2019 Sep;29(11):544-559. doi: 10.1016/j.purol.2019.05.002. Epub 2019 May 29.
The diastasis of the rectus abdominis muscles is common during pregnancy and post-partum.
To determine the prevalence of this pathology, methods of diagnosis, association with pelvic-perineal disorders and therapies that may be proposed.
Review of Pubmed, Medline, Embase and Cochrane literature using the following words and MeSH: diastasis, diastasis and pregnancy, diastasis of the rectus abdominis muscle, increase of the inter-recti distance.
Among the 124 articles found, 61 were selected. Ultrasound seems to be the exam of choice both in terms of feasibility and reproducibility for the diagnosis of this pathology (intra-class correlation coefficients (ICC) high 0.81 to 0.94). The risk factors identified vary from one study to another: heavy load bearing (OR=2.18 (95 % CI 1.05 to 4.52) P=0.04), weight gain. Studies are discordant regarding the association between diastasis and low back pain (RR=1.39 (95 % CI 0.91-2.14), P=0.17), urinary incontinence (RR=0.86 (95 % CI 0.55-1.33) P>0.65) and prolapse (OR=2.25 (95 % CI 1.51-3.37) P<0.001), but the diastasis seems to play a role in the alteration of the quality of life for these patients.
Knowledge about risk factors, consequences of diastasis and management is still limited today. It is therefore necessary to establish prospective studies on larger numbers in order to improve knowledge on the diastasis of the rectus abdominis muscles.
腹直肌分离在孕期和产后很常见。
确定这种病症的患病率、诊断方法、与盆腔 - 会阴疾病的关联以及可能推荐的治疗方法。
使用以下关键词和医学主题词（MeSH）检索PubMed、Medline、Embase和Cochrane文献：腹直肌分离、腹直肌分离与妊娠、腹直肌分离、腹直肌间距增加。
在检索到的124篇文章中，选取了61篇。就诊断这种病症的可行性和可重复性而言，超声似乎是首选检查（组内相关系数（ICC）较高，为0.81至0.94）。不同研究确定的风险因素各不相同：负重（OR = 2.18（95%可信区间1.05至4.52），P = 0.04）、体重增加。关于腹直肌分离与腰痛（RR = 1.39（95%可信区间0.91 - 2.14），P = 0.17）、尿失禁（RR = 0.86（95%可信区间0.55 - 1.33），P>0.65）和脱垂（OR = 2.25（95%可信区间1.51 - 3.37），P<0.001）之间的关联，各项研究结果不一致，但腹直肌分离似乎对这些患者的生活质量改变有影响。
目前关于腹直肌分离的风险因素、后果及管理的知识仍然有限。因此，有必要开展更大规模的前瞻性研究，以增进对腹直肌分离的了解。
