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二维超声联合剪切波弹性成像对妊娠相关腹直肌分离的前瞻性研究。

A prospective study of two-dimensional ultrasonography combined with shear wave elastography for pregnancy-related diastasis recti abdominis.

作者信息

Wang Li, Yun Ting, Zhang Dong, Zhong Jianrong, Yi Dan, Fu Wanxi, Li Molin, Zhang Yunshan, Wang Yuexiang

机构信息

Graduate School of the PLA General Hospital, Beijing, China.

Department of Ultrasound, The Six Medical Center of Chinese PLA General Hospital, Beijing, China.

出版信息

Front Physiol. 2024 May 27;15:1382982. doi: 10.3389/fphys.2024.1382982. eCollection 2024.

DOI:10.3389/fphys.2024.1382982
PMID:38860113
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11163132/
Abstract

OBJECTIVES

To compare the inter-rectus distance (IRD), rectus abdominis thickness (RAT), and stiffness in women during pregnancy and postpartum and identify the risk and protective factors affecting diastasis recti abdominis (DRA).

MATERIALS AND METHODS

A total of 171 pregnant women who volunteered to participate in this study were recruited. Using an ultrasonographic diagnostic instrument with shear wave elastography function, IRD, RAT and the Young's modulus of the rectus abdominis muscles were measured at 12 weeks, 37 weeks of pregnancy, and 6 weeks postpartum.

RESULTS

The IRD at 37 weeks was significantly higher than that at 12 weeks and then decreased at 6 weeks postpartum, but it was still higher than that at 12 weeks ( < 0.001). RAT and Young's modulus decreased significantly at 37 weeks compared with those at 12 weeks and then recovered at 6 weeks postpartum, but they were lower than those at 12 weeks ( < 0.001). IRD at 12 weeks was significantly higher in multiparae than in primiparae ( < 0.001). Moreover, positive correlation between the RAT and Young's modulus of rectus abdominis muscles at 12 and 37 weeks of gestation and 6 weeks postpartum ( < 0.001) was observed. Multiple linear regression analysis showed that the regression equation was significant (f = 24.856, < 001).

CONCLUSION

Our study identified differences in IRD, thickness and stiffness of the rectus abdominis muscle between early and advanced pregnancy and the postpartum period. The risk and protective factors of DRA may guide pregnant women's protection and treatment.

摘要

目的

比较孕期和产后女性的腹直肌间距(IRD)、腹直肌厚度(RAT)和硬度,并确定影响腹直肌分离(DRA)的风险和保护因素。

材料与方法

招募了171名自愿参与本研究的孕妇。使用具有剪切波弹性成像功能的超声诊断仪,在妊娠12周、37周和产后6周测量IRD、RAT和腹直肌的杨氏模量。

结果

37周时的IRD显著高于12周时,产后6周时下降,但仍高于12周时(<0.001)。与12周时相比,37周时RAT和杨氏模量显著下降,产后6周时恢复,但低于12周时(<0.001)。经产妇12周时的IRD显著高于初产妇(<0.001)。此外,观察到妊娠12周、37周和产后6周时腹直肌的RAT与杨氏模量之间呈正相关(<0.001)。多元线性回归分析表明回归方程具有显著性(f = 24.856,<0.001)。

结论

我们的研究发现了妊娠早期、晚期和产后腹直肌在IRD、厚度和硬度方面的差异。DRA的风险和保护因素可能为孕妇的保护和治疗提供指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/7183fed5b95b/fphys-15-1382982-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/606f9c231666/fphys-15-1382982-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/a833922e16ab/fphys-15-1382982-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/21aa4cc4df5a/fphys-15-1382982-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/7183fed5b95b/fphys-15-1382982-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/606f9c231666/fphys-15-1382982-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/a833922e16ab/fphys-15-1382982-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/21aa4cc4df5a/fphys-15-1382982-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4652/11163132/7183fed5b95b/fphys-15-1382982-g004.jpg

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Eur J Obstet Gynecol Reprod Biol. 2023 Jun;285:24-30. doi: 10.1016/j.ejogrb.2023.03.040. Epub 2023 Apr 1.
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Int J Sports Physiol Perform. 2022 Nov 11;17(12):1725-1731. doi: 10.1123/ijspp.2022-0094. Print 2022 Dec 1.
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