二维超声联合 SWE 技术在孕产妇腹直肌评估中的应用价值.

Objective To evaluate the distance between rectus abdominis muscle (IRD)and the hardness of primipara during the pregnancy and early postpartum by using two-dimensional ultrasound combined with shear wave elastography (SWE), and to explore the correlation between IRD and the hardness of primipara. Methods From October 2021 to August 2022, a total of 250 primipara who received the regular birth check-up in the Affiliated Hospital of Yunnan University and delivered at full term were selected. During the pregnancy, they were divided into the early pregnancy group, the middle pregnancy group and late pregnancy group based on the gestational age.After the birth, they were then were divided into the natural birth group and the cesarean section group based on the delivery mode. Another 50 healthy non-pregnant women were selected as the control group. The mean elastic modulus of rectus abdominis (Emean) was measured by two-dimensional ultrasound and SWE. The differences of IRD and the rectus abdominis hardness during the pregnancy and postpartum were compared, and the correlation between them was analyzed. Results IRD and the hardness increased with the gestational age and the difference was statistically significant (P < 0.01). IRD of the cesarean section group was higher than that of the vaginal delivery group, and the hardness was lower than that of the vaginal delivery group. BMI during the pregnancy IRD was positively correlated with IRD and the hardness of rectus abdominis muscle (r p = 0.515, 0.641, 0.564, 0.483, 0.513, 0.462, P < 0.01) and IRD was positively correlated with the hardness of rectus abdominis muscle (r p = 0.559, 0.580, 0.425, P < 0.01). Postpartum BMI had no correlation with the hardness of rectus abdominis muscle (r p = −0.113, −0.071, −0.043, −0.005, −0.086, −0.045, P > 0.05), and IRD was negatively correlated with the hardness at 3cm below the umbilical cord (r p = −0.227, P = 0.023). Conclusion　It is feasible to evaluate IRD and the rectus abdominis hardness by 2D ultrasound combined with SWE, which can provide more intuitive clinical basis for the diagnosis and treatment of postpartum rectus abdominis separation. [ABSTRACT FROM AUTHOR]