Title : Exploring mechanical changes in the transversus abdominis muscle following cesarean delivery in postpartum women
Abstract:
Background: Not only pregnancy may be associated with weakness of abdominal muscles including the Transversus Abdominis muscle but also, Cesarean delivery may contribute to this weakness. This study assessed the maximum voluntary isometric contraction (MVIC) of the core muscle; The Transversus Abdominis (TrA) among women undergoing: cesarean delivery, and vaginal delivery, and compared them to those without previous pregnancy.
Methods: The study design was a historical cohort study that included 95 women classified into: Group A; 40 women who underwent cesarean delivery, the control positive group (Group B); and 15 women who underwent vaginal delivery. Women in these two groups were assessed at 6-12 weeks postpartum. The control negative group (Group C); included 40 women who never experienced pregnancy. The pressure Biofeedback device was used to measure the MVIC of the TrA.
Results: The Kruskal-Wallis test revealed a significant difference in TrA strength (P=0.001), and the Bonferroni test showed significant differences in pairwise groups A&C and A&B, however, there was a non-significant difference between groups B&C.
Conclusion: Women undergoing cesarean delivery exhibited a remarkable decrease in their TrA strength compared to those undergoing vaginal delivery or those of the control negative group. On the other hand, a non-remarkable decrease in the TrA strength was found in women of the vaginal delivery group compared to those of the control negative group. Cesarean delivery may be associated with weakness of the core muscle; the TrA.
Audience Take Away:
- Women who underwent Cesarean delivery – 6 to 12 weeks postpartum - may show weakness in the Transversus Abdominis muscle which is one important local core muscle participating in spinal stability.
- Encouraging Vaginal delivery because it was associated with a statistically non-significant decrease in the TrA strength compared to those who had never been pregnant.
- For those who are eligible for cesarean delivery, a focused exercise program to improve the TrA strength should be considered during both antenatal and postnatal periods.
