Obstetric 6 Flashcards
What is diastasis recti? (DR)
separation of greater than 2 fingertip widths of the 2 bellies of the RA at the linea alba
linea alba = this during pregnancy
linea nigra
In addition to pregnant women, who else gets DR?
people with
- chronic pulmonary conditions
- children younger than 2
- men with beer bellies
DR: painful?
no
DR linked to:
- LBP
- UI
- may be correlated to altered intra-abdominal pressure gradients
DR resolution
can spontaneously resolve
DR assessment
- have pt perform curlup while PT palpates between 2 sides of contracted recti
- note number of fingertips able to place within separation
DR tx
- TrA work or other exercises that don’t result in increased intraabdominal pressure
- should work to eliminate DR prior to beginning more intense abdominal work
- may need to refer to WCS
cesarean delivery =
delivery through abdominal wall
% births done by c-section
~30%
reasons for c-section
- prior c-section
- labor dystocia
- fetal distress
- breech presentation
risk of vaginal birth after a c-section birth
associated with small but significant risk of uterine rupture
Where is surgical approach for c-section made?
- transversely through lower uterine segment
- above pubic bone
teen pregnancy: at increased risk for
- preterm labor
- psychological problems
teen pregnancy: complicated by
- incomplete pelvic growth
- lack of psychological maturity
- lack of prenatal care
- inadequate weight gain
Why do teen pregnancies have inadequate weight gain?
pregnant teens grow at slower rate as compared to peers
mortality rates: teen vs. adult
pregnant adolescents have more than 2x the mortality rate of pregnant women
precautions for exam and tx: what to avoid
abd compression
positions that involve abdominal compression in mid-late pregnancy (prone flat lying)
precautions for exam and tx: what to avoid
supine
positions in supine longer than a few minutes after 4th month
- supine hypotension syndrome
- pressure on inferior vena cava
precautions for exam and tx: what to avoid
straining
activities that strain the pelvic floor and abdominal muscles
precautions for exam and tx: what to avoid
stretching
vigorous stretching of hip adductors (pubic symphysis)
precautions for exam and tx: what to avoid
balance
positions that require rapid balance changes
precautions for exam and tx: what to avoid
temp
- overheating (fetal health concern with increased maternal core temp)
- deep heat, estim over trunk
postpartum issues that require special consideration for PT
changes in
- strength
- endurance
- generalized ligamentous integrity
- pelvic floor
- other tissues
