Ultrasound Assessment of Abdominal Muscle Thickness in Postpartum vs Nulliparous Women

J Manipulative Physiol Ther. 2015 Jun;38(5):352-7. doi: 10.1016/j.jmpt.2015.06.005.


Objective: The purpose of this study was to determine the effect size in measurable change of abdominal musculature morphology using ultrasonography in postpartum women within 1 month of a healthy, vaginal delivery.

Methods: One hundred fifty-six participants were recruited for this study. B-mode ultrasound imaging was used to measure abdominal muscle thickness on 80 nulliparous women and 76 mothers who had delivered within the past 4 weeks. Measures were taken for the upper and lower rectus abdominus, external and internal obliques, and transversus abdominus at rest.

Results: Statistically significant differences were found in the thickness of the rectus abdominus muscle at both sites; upper (P < .0001) and lower (P < .0001) as well as the internal oblique (P < .0001). All 3 muscles were thinner in postpartum participants (8.29 ± 1.83 mm, 8.89 ± 2.29 mm, and 7.06 ± 1.82 mm, respectively) within the first month of delivery than in controls (10.82 ± 1.93 mm, 11.13 ± 2.38 mm, and 8.36 ± 1.87 mm, respectively). Large effect sizes were found for the influence of pregnancy on the rectus muscle segments (1.35 for the upper rectus abdominus and 1.00 for the lower rectus abdominus) and a medium effect size for the internal oblique (0.71). No significant differences were observed in the remaining 2 muscles.

Conclusion: This study showed that there are differences in morphology of the abdominal muscles in pregnant women vs nonpregnant controls. The large effect sizes reported may provide the basis for future studies examining relationships between morphology, functional change, and back pain during pregnancy.

Keywords: Abdominal Muscles; Back Pain; Postpartum Period; Pregnancy; Ultrasonography.

Publication types

  • Comparative Study

MeSH terms

  • Abdominal Muscles / physiology*
  • Abdominal Muscles / ultrastructure*
  • Adult
  • Female
  • Humans
  • Muscle Contraction / physiology*
  • Parity
  • Pelvic Floor / physiology
  • Postpartum Period*
  • Rectus Abdominis / diagnostic imaging
  • Rectus Abdominis / ultrastructure
  • Reference Values
  • Ultrasonography
  • Young Adult