Case 10: Plication of rectus diastasis 2 years after twin-birth
Theresia Skytte Eriksen, Helle Sjøstrand and Ida Felbo Pold
Published · April 2, 2025
Keywords: Rectus Diastasis, Plication, Abdominoplasty, following pregnancy Authors: Theresia Skytte Eriksen, Helle Sjøstrand and Ida Felbo Pold. Institution: Department of Plastic Surgery, Herlev and Gentofte Hospital, Denmark Abstract 38-year-old woman underwent plication of symptomatic diastasis of the rectus abdominal muscles after twin-birth by caesarean section. The diastasis had a maximal width of 6,6 cm just above the umbilicus and her symptoms included core-instability, back-pain, and a feeling of being unprotected around her abdomen especially while handling her children. Patient medical history 38-year-old woman had after twin-birth developed symptomatic diastasis of the rectus abdominal muscles. She had no comorbidities. She had an older child of 6 years, and the twins were 2 years old. All children were delivered by uncomplicated caesarean section. The patient described symptoms as back-pain, nausea, core instability, discomfort during running, and pain when encountering pressure to the abdomen especially while handling the children. Physical rehabilitation with physiotherapists had not been successful and hard to complete do to discomfort and pain. Before and After Patient examination The patient was initially examined 15 months postpartum and at an additionally examination two years postpartum by the same surgeon. A preoperative CT-scan at 15 months postpartum, showed a rectus diastasis with the maximal width of 6,6 cm just above the umbilicus. The objective examination confirmed those findings, and a small umbillical hernia was detected. No change in symptoms and width of the diastasis was found between the two examinations. Pre-operative considerations Physical training alone has not been found to reduce the width of the diastasis [1]. Surgery was in one randomized controlled trial superior to physical training with regard to reduction of pain and increase abdominal muscle strength [2]. The swedish guidelines currently recommend that surgery is indic
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References
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