Sudden Diastasis of Rectus Abdominis During Labor: A Case Report

We present a case of a nulliparous patient with a sudden diastasis of rectus abdominis (DRA) during labor. DRA is defined in literature as a separation of 2 muscle bellies of rectus abdominis of more than 2 fingerbreadths either 4.5 cm above or below the umbilicus.1 DRA is clinically recognized; however, there is limited knowledge on the prevalence, risk factors, and complications of DRA. Here, we present a patient who had an abrupt DRA during labor with herniation of bowel anterior to the fundus with associated abdominal pain. Due to similarity in presentation as uterine rupture, this case resulted in an elective cesarean delivery. Thus, this case report highlights the need to review DRA and uterine rupture and the associated risk factors to help health care professionals make prompt diagnoses and avoid elective primary cesarean delivery in an otherwise healthy, nulliparous patient.