Obstetric 6

Question 1

What is diastasis recti? (DR)

Answer 1

separation of greater than 2 fingertip widths of the 2 bellies of the RA at the linea alba

Question 2

linea alba = this during pregnancy

Answer 2

linea nigra

Question 3

In addition to pregnant women, who else gets DR?

Answer 3

people with

• chronic pulmonary conditions
• children younger than 2
• men with beer bellies

Question 4

DR: painful?

Answer 4

no

Question 5

DR linked to:

Answer 5

• LBP
• UI
• may be correlated to altered intra-abdominal pressure gradients

Question 6

DR resolution

Answer 6

can spontaneously resolve

Question 7

DR assessment

Answer 7

• have pt perform curlup while PT palpates between 2 sides of contracted recti
• note number of fingertips able to place within separation

Question 8

DR tx

Answer 8

• 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

Question 9

cesarean delivery =

Answer 9

delivery through abdominal wall

Question 10

% births done by c-section

Answer 10

~30%

Question 11

reasons for c-section

Answer 11

• prior c-section
• labor dystocia
• fetal distress
• breech presentation

Question 12

risk of vaginal birth after a c-section birth

Answer 12

associated with small but significant risk of uterine rupture

Question 13

Where is surgical approach for c-section made?

Answer 13

• transversely through lower uterine segment

- above pubic bone

Question 14

teen pregnancy: at increased risk for

Answer 14

• preterm labor

- psychological problems

Question 15

teen pregnancy: complicated by

Answer 15

• incomplete pelvic growth
• lack of psychological maturity
• lack of prenatal care
• inadequate weight gain

Question 16

Why do teen pregnancies have inadequate weight gain?

Answer 16

pregnant teens grow at slower rate as compared to peers

Question 17

mortality rates: teen vs. adult

Answer 17

pregnant adolescents have more than 2x the mortality rate of pregnant women

Question 18

precautions for exam and tx: what to avoid

abd compression

Answer 18

positions that involve abdominal compression in mid-late pregnancy (prone flat lying)

Question 19

precautions for exam and tx: what to avoid

supine

Answer 19

positions in supine longer than a few minutes after 4th month

• supine hypotension syndrome
• pressure on inferior vena cava

Question 20

precautions for exam and tx: what to avoid

straining

Answer 20

activities that strain the pelvic floor and abdominal muscles

Question 21

precautions for exam and tx: what to avoid

stretching

Answer 21

vigorous stretching of hip adductors (pubic symphysis)

Question 22

precautions for exam and tx: what to avoid

balance

Answer 22

positions that require rapid balance changes

Question 23

precautions for exam and tx: what to avoid

temp

Answer 23

• overheating (fetal health concern with increased maternal core temp)
• deep heat, estim over trunk

Question 24

postpartum issues that require special consideration for PT

Answer 24

changes in

• strength
• endurance
• generalized ligamentous integrity
• pelvic floor
• other tissues