Multi-dimensional Evaluation of Diastasis Recti Abdominis by Ultrasound during Different Pregnancy and Perinatal Period

Background: To explore the application value of two-dimensional ultrasound and shear wave elastography (SWE) in the evaluation of diastasis recti abdominis (DRA) in different dimensions during perinatal period. Methods From June 2021 to September 2022, 26 cases of the first trimester (< 14 weeks), 36 cases of 14–27 weeks, 36 cases of 28–34 weeks, 32 cases of 35–38 weeks, 45 cases of postpartum 42 days and 27 cases of postpartum 3 months were identified. Inter-rectus distance (IRD) and muscle thickness measurements were taken by B-mode ultrasound. SWE values were acquired by two operators. IRD, thickness and SWE, were compared during different period using one-way ANOVA or Kruskal-Wallis. Spearman correlation analyses were conducted for the variables of IRD, thickness, BMI, neonatal weight, delivery mode, and SWE. Bland-Altman plot was used to analyze SWE of rectus abdominis as a reliability index. Results IRD and SWE did not return to the early level ( P  < 0.001, P  < 0.001), but the muscle thickness had no significant difference ( P  = 0.211). SWE was negatively correlated with IRD ( r =-0.515), positively correlated with muscle thickness ( r  = 0.408), negatively correlated with BMI (r=-0.296), but not significantly correlated with neonatal weight and delivery mode ( P  = 0.147, 0.648). Bland-Altman plot showed that different operators have better consistency. Conclusions Multi-dimensional evaluation of DRA by ultrasound is feasible. IRD and SWE values can be used to evaluate the recovery of postpartum DRA, and the combination of them can objectively reflect the morphological and functional severity of DRA.