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Diastasis recti

Definition

Diastasis recti is a separation between the left and right side of the rectus abdominis muscle, which covers the front surface of the belly area.

Causes, incidence, and risk factors

Diastasis recti is a common and normal condition in newborns. It is seen most frequently in premature and African American infants.

In pregnant women, increased tension on the abdominal wall may lead to diastasis recti. Multiple births or repeated pregnancies increase the risk.

Women who are 12 or more weeks pregnant should avoid aggressive abdominal exercises, which may worsen the condition.

Symptoms

A diastasis recti looks like a ridge, which runs down the middle of the belly area. It stretches from the bottom of the breastbone to the belly button, and increases with muscle straining.

In infants, the condition is most easily seen when the baby tries to sit up. It may not be seen when the child lies on the back and is relaxed. When the infant is relaxed, you can often feel the edges of the rectus muscles.

Diastasis recti is commonly seen in women who have multiple pregnancies, because the muscles have been stretched many times. Extra skin and soft tissue in the front of the abdominal wall may be the only signs of this condition in early pregnancy. In the later part of pregnancy, the top of the pregnant uterus is often seen bulging out of the abdominal wall. An outline of parts of the unborn baby may be seen in some severe cases.

Signs and tests

The doctor can diagnose this condition by performing a physical exam.

Treatment

No treatment is needed for pregnant women with this condition.

In infants, the rectus abdominis muscles continue to grow and the diastasis recti gradually disappears. Surgery may be needed if the baby develops a hernia that becomes trapped in the space between the muscles.

Expectations (prognosis)

The patient usually does very well. In most cases, diastasis recti usually heals on its own.

Pregnancy-related diastasis recti usually persists long after the woman gives birth. Exercise may help improve the condition. Umbilical hernia may occur in some cases. If pain is present, surgery may be needed.

Complications

In general, complications only result when a hernia develops.

Calling your health care provider

Call your health care provider immediately if a child with diastasis recti develops redness or pain in the abdomen, has persistent vomiting, or cries constantly.

References

Marx, J. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 7th ed. St. Louis, Mo: Mosby; 2009.

Anderson, DM. Mosby's Medical Dictionary. 8th ed. St. Louis, Mo: Mosby; 2009.


Review Date: 6/17/2011
Reviewed By: Kimberly G Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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