Pelvic floor muscle dysfunction at 3D transperineal ultrasound in maternal exposure to gestational diabetes mellitus: A prospective cohort study during pregnancy

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dc.contributor.authorPinheiro, Fabiane A. [UNESP]
dc.contributor.authorSartorão Filho, Carlos I. [UNESP]
dc.contributor.authorPrudencio, Caroline B. [UNESP]
dc.contributor.authorNunes, Sthefanie K. [UNESP]
dc.contributor.authorPascon, Tawana [UNESP]
dc.contributor.authorHallur, Ragavendra L. S. [UNESP]
dc.contributor.authorTakano, Luis [UNESP]
dc.contributor.authorEnriquez, Eusébio M. A. [UNESP]
dc.contributor.authorCatinelli, Bruna B. [UNESP]
dc.contributor.authorCarr, Aline M. [UNESP]
dc.contributor.authorJunginger, Baerbel
dc.contributor.authorRudge, Marilza V. C. [UNESP]
dc.contributor.authorBarbosa, Angélica M. P. [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionAssis Municipality Educational Foundation (FEMA)
dc.contributor.institutionPravara Institute of Medical Sciences (Deemed to be University)
dc.contributor.institutionCharitè University Hospital
dc.date.accessioned2023-03-01T20:51:16Z
dc.date.available2023-03-01T20:51:16Z
dc.date.issued2022-06-01
dc.description.abstractAim: This study aimed to assess, for the first time, the dynamic morphometry of pelvic floor muscles (PFM) using three-dimensional transperineal ultrasound (3D-TPUS) and its progression at two-time points of gestation between women with and without gestational diabetes mellitus (GDM), and whether the PFM dysfunction is connected to GDM. Methods: The study comprised 83 consecutive pregnant women with (n = 38) and without (n = 45) GDM screened at 24–30 and 38–40 weeks of gestation. 3D-TPUS and a mobility test were used to quantify PFM dynamic morphometry during maximum contraction and the Valsalva maneuver. Results: When compared to the control group, GDM women had no significant variations in all levator hiatal dimensions at 24–30 weeks of gestation. Meanwhile, women with GDM experienced an increase in levator hiatal area (LHa) (p < 0.000) during PFM contraction and enlargement in LHa (p < 0.001) during Valsalva maneuver (p = 0.010) at 38–40 weeks of gestation. As a result, the mobility index among GDM women had a lower value (p = 0.000). The dynamic morphometry development of PFM in GDM women at two stages during pregnancy revealed a substantial decrease (p = 0.000) in all LHa dimensions of contraction, distension, and mobility. Conclusions: Using 3D-TPUS, we found that GDM women had a specific pattern of PFM functional changes in the third trimester of pregnancy. These initial findings revealed alterations in PFM functionality, such as decreased contractility, distensibility, or mobility. This dysfunctional PFM could contribute to the long-term development of pelvic floor dysfunction years after a GDM pregnancy.en
dc.description.affiliationPostgraduate Program on Tocogynecology Botucatu Medical School (FMB) São Paulo State University (UNESP), São Paulo State
dc.description.affiliationDepartment of Medical Health Medical School Fundação Educacional do Município de Assis (FEMA Assis Municipality Educational Foundation (FEMA), São Paulo State
dc.description.affiliationCenter for Biotechnology Pravara Institute of Medical Sciences (Deemed to be University), Maharashtra
dc.description.affiliationDepartment of Gynecology Pelvic Floor Center Charitè Charitè University Hospital
dc.description.affiliationDepartment of Physiotherapy and Occupational Therapy School of Philosophy and Sciences São Paulo State University (UNESP), São Paulo State
dc.description.affiliationUnespPostgraduate Program on Tocogynecology Botucatu Medical School (FMB) São Paulo State University (UNESP), São Paulo State
dc.description.affiliationUnespDepartment of Physiotherapy and Occupational Therapy School of Philosophy and Sciences São Paulo State University (UNESP), São Paulo State
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipIdFAPESP: 2021/10665-6
dc.description.sponsorshipIdFAPESP: FAPESP-2016/01743-5
dc.format.extent1127-1138
dc.identifierhttp://dx.doi.org/10.1002/nau.24927
dc.identifier.citationNeurourology and Urodynamics, v. 41, n. 5, p. 1127-1138, 2022.
dc.identifier.doi10.1002/nau.24927
dc.identifier.issn1520-6777
dc.identifier.issn0733-2467
dc.identifier.scopus2-s2.0-85132453652
dc.identifier.urihttp://hdl.handle.net/11449/241195
dc.language.isoeng
dc.relation.ispartofNeurourology and Urodynamics
dc.sourceScopus
dc.subject3D transperineal ultrasound
dc.subjectgestational diabetes mellitus
dc.subjectmuscle contraction
dc.subjectpelvic floor muscle
dc.subjectpregnancy
dc.subjectvalsalva maneuver
dc.titlePelvic floor muscle dysfunction at 3D transperineal ultrasound in maternal exposure to gestational diabetes mellitus: A prospective cohort study during pregnancyen
dc.typeArtigo
unesp.author.orcid0000-0003-4710-3392[2]
unesp.author.orcid0000-0002-2070-3606[3]
unesp.author.orcid0000-0003-4744-1930[4]
unesp.author.orcid0000-0003-4879-3014[11]
unesp.author.orcid0000-0002-9227-832X[12]
unesp.author.orcid0000-0003-0817-9511[13]

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