剖宫产时直肌重新逼近：一项随机对照试验

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

European journal of obstetrics, gynecology, and reproductive biology Pub Date : 2025-04-09 DOI:10.1016/j.ejogrb.2025.113966

Berna Aslan Cetin , Fitnat Topbas , Kübra Keskin Toptas , Merve Konal , Gökalp Senol

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引用次数: 0

摘要

目的探讨剖宫产术中腹直肌复位对术后疼痛和腹直肌移位的影响。该研究计划于2019年12月至2021年3月在我院临床进行前瞻性随机研究。研究组包括妊娠37 周，首次行乳糜泻，既往无盆腔或腹部手术史，18-40 岁的妇女。患者被随机分为直肌矫正组和对照组。分别于术后第1天和第6周对患者进行评估。主要观察指标为各组视觉模拟量表（VAS）评分和直肌间距离（IRD）的比较。此外，还使用逻辑回归分析了与直肌转移相关的因素。结果本组共306例初诊剖宫产妇女，其中296例纳入最终分析。两组患者VAS评分及术后镇痛需求差异无统计学意义。术后第6周，直肌重组组脐下ird2 cm明显缩短。logistic回归分析显示，腹直肌重新逼近对脐下腹直肌移位的发展有负向影响（OR = 2.830,p = 0.013）。结论CD时腹直肌的重新逼近使脐下腹直肌转移减少。另一方面，它不影响术后VAS评分。

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Rectus muscle reapproximation at cesarean delivery: a randomized controlled trial

Objective

The aim of our study was to investigate the effect of rectus muscle reapproximation at cesarean delivery (CD) on postoperative pain and rectus muscle diastasis.

Methods

Our study was planned as a prospective, randomized study in our clinic between December 2019 and March 2021. The study group included women >37 weeks of gestation, undergoing CD for the first time, with no prior history of pelvic or abdominal surgery, 18–40 years of age. Patients were randomly assigned to either the rectus muscle reapproximation group or the control group. Patients were evaluated at postoperative 1st day and 6th week. The primary outcome was the comparison of the Visual Analogue Scale (VAS) score and inter-rectus diatance (IRD) among the groups. Additionally, factors associated with rectus diastasis were also analyzed using logistic regression.

Results

A total of 306 women undergoing primary cesarean sections were randomized, and 296 were included in the final analysis. There was no significant difference in terms of VAS score and postoperative analgesia need among the groups. IRD 2 cm below umbilicus was significantly shorter in rectus muscle reapproximation group at postoperative 6th week. The logistic regression analysis showed that rectus muscle reapproximation had a negative impact on the development of rectus diastasis below umbilicus (OR = 2.830, p = 0.013).

Conclusion

Rectus muscle reapproximation during CD resulted in less rectus diastasis below umbilicus. On the other hand it did not affect postoperative VAS score.

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来源期刊

European journal of obstetrics, gynecology, and reproductive biology 医学-妇产科学

CiteScore

4.60

自引率

3.80%

发文量

898

审稿时长

8.3 weeks

期刊介绍： The European Journal of Obstetrics & Gynecology and Reproductive Biology is the leading general clinical journal covering the continent. It publishes peer reviewed original research articles, as well as a wide range of news, book reviews, biographical, historical and educational articles and a lively correspondence section. Fields covered include obstetrics, prenatal diagnosis, maternal-fetal medicine, perinatology, general gynecology, gynecologic oncology, uro-gynecology, reproductive medicine, infertility, reproductive endocrinology, sexual medicine and reproductive ethics. The European Journal of Obstetrics & Gynecology and Reproductive Biology provides a forum for scientific and clinical professional communication in obstetrics and gynecology throughout Europe and the world.