The Study Of Rectus Abdominis In Postpartum Women On Ultrasound Imaging

1.ObjectiveHigh frequency ultrasound imaging technology was used to observe the structural changes of rectus abdominis in postpartum periods,including rectus abdominis separation distance and rectus abdominis thickness,and to predict the dynamic changes of rectus abdominis separation distance and rectus abdominis thickness in the postpartum stage,so as to provide certain quantitative information for clinic,and provide objective quantitative basis or index for the formulation of postpartum rehabilitation treatment plan and risk factors Analysis,treatment timing.2.Methods2.1 selection of research objects:A total of 340 patients in our hospital from January 2014 to December 2018 were randomly selected.There were 280 healthy parturients in the experimental group,and 60 healthy volunteers in the control group were selected at the same time,the women without pregnancy history matched with the age and BMI of the experimental group.2.2 instrument setting:The Toshiba APLIO 500 TUS-A500 color Doppler ultrasound diagnostic apparatus were used,and the frequency of linear probe was 7.5-12 MHz.2.3 examination:The subjects were in the supine position with bilateral knee flexion of about 60-120 ° to relax the abdominal muscles as much as possible.Appropriate amount of couplant was applied to the abdominal wall.High frequency ultrasound probe was used to identify the bilateral rectus abdominis and the linea alba.When the subjects were in a state of calm,sliding downward from the xiphoid process to the pubic area,the distance between the inner edge of bilateral rectus abdominis was measured,and the maximum value was defined as the ‘separation distance of rectus abdominis’.The distance between the anterior layer of Tunica vaginalis rectus abdominis and the posterior layer of Tunica vaginalis rectus abdominis was measured,and the maximum value was defined as the ‘thickness of rectus abdominis’.The position where the maximum value was measured for the first time was marked as the specific measurement position of the subject,and the position was taken as the measurement position in the follow-up measurement process of the subject.Each measurement was repeated three times,and the average value was taken as the recorded value.2.4 data analysis:The subjects were divided into seven groups: women on the first day after delivery were included in the Experimental group I,women 1 month after delivery were included in the Experimental group II,women 2 months after delivery were included in the Experimental group III,women 3 months after delivery were included in the Experimental group IV,women 6months after delivery were included in the Experimental group V,and women 12 months after delivery were included in the Experimental group VI,healthy women without pregnancy history matched with the age and BMI of the experimental group were recruited into the control group.The separation distance of rectus abdominis and the thickness of rectus abdominis were measured respectively,and the statistical differences were compared and analyzed,between the experimental group and the control group,and all experimental groups.3.Results3.1 thickness of rectus abdominis muscle:Experimental group I,experimental group II,experimental group III,experimental group IV,experimental group V,experimental group VI were less than the control group,the difference between the experimental group and the control group was statistically significant(P< 0.05)Experimental group Ⅲ < experimental group Ⅱ < experimental group Ⅰ < control group;(P < 0.05)Experimental group III < experimental group IV < experimental group V < experimental group VI.(P<0.05)3.2 separation distance of rectus abdominis muscle:Experimental group I,experimental group II,experimental group III,experimental group IV,experimental group V and experimental group VI were all larger than those in the control group,and the differences between the experimental group and the control group were statistically significant(P < 0.05)Experimental group II,experimental group III,experimental group IV,experimental group V,experimental group VI were less than experimental group I,and there were significant differences between experimental group II,experimental group III,experimental group IV,experimental group V,experimental group VI and experimental group I(P < 0.05)There was no significant difference among experimental group II,experimental group III,experimental group IV and experimental group V.(P>0.05)4.ConclusionThe rectus abdominis relaxation and rectus abdominis separation in postpartum women have positive correlation with pregnancy factors.The rectus abdominis has continuous adaptive dynamic changes in a period of postpartum time,and there are rules to follow: the rectus abdominis continues to relax in a period of postpartum time,and the rectus abdominis thickness gradually recovers in 2 months after delivery,but it still does not return to the level of the Control group until 12 months after delivery;The separation distance of rectus abdominis continued to widen in a period of time after delivery.The separation distance of rectus abdominis significantly shortened at 1 month after delivery,but it did not return to the level of the control group until 12 months after delivery.The separation distance of rectus abdominis was in the plateau period from 1 month after delivery to 12 months after delivery.The results of this study can provide a valuable basis for clinical research,and have a certain clinical value for the pathogenesis and risk factors of postpartum low back pain and other clinical symptoms,especially for the formulation of personalized program and the choice of treatment opportunity in postpartum rehabilitation treatment.