Frequência de diástase do reto abdominal e incontinência urinária em mulheres submetidas ao parto vaginal e cesárea.

Abstract

Introduction: During the pregnancy cycle, the woman undergoes intense changes in the body, triggered by anatomical, biomechanical, hormonal, physiological and psychological changes. As pregnancy progresses, uterine growth occurs through fetal development, and diastasis of the rectus abdominis muscle and urinary incontinence may occur. Diastasis involves the functioning of the muscles of the abdomen, causing an increase in intra-abdominal pressure and also predisposing to urinary loss during pregnancy and postpartum. Objective: To correlate the frequency of diastasis recti abdominis and urinary incontinence in primiparous and multiparous women undergoing vaginal delivery and cesarean section. Methodology: This is a descriptive cross-sectional study of a qualitative and quantitative nature. Participants were women who underwent vaginal delivery and cesarean delivery in 2020 and 2021 aged between 18 and 35 years. The Urinary Incontinence Impact Questionnaire was applied to investigate symptoms of urinary loss by the woman's perception and the palpation test of the diastasis of the rectus abdominis was performed. Results: Four women aged between 24 and 34 participated, three multiparous with vaginal deliveries and episiotomy (A, C, D) and one primiparous with cesarean delivery (B). As for urinary losses in the immediate and late puerperium, two participants (C and D) presented UI and one woman (D) also presented diastasis of the rectus abdominis (higher at the umbilical level). Final considerations: The multiparous participant (D) who presented the two associated conditions, diastasis and urinary incontinence, is sedentary with normal body mass in the late postpartum period, but had a large increase in body mass during both pregnancies, just as the babies were older at birth. The two participants (A and B) who regularly practice street running for years, did not present urinary loss or diastasis, but urinary incontinence of low impact on quality of life was observed in two women who underwent vaginal delivery, and in one of these, the associated diastasis of the rectus abdominis.