Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Nov;39(8):2329-2337.
doi: 10.1002/nau.24491. Epub 2020 Aug 28.

Impact of gestational diabetes on pelvic floor: A prospective cohort study with three-dimensional ultrasound during two-time points in pregnancy

Carlos I Sartorão Filho  1   2 , Fabiane A Pinheiro  1 , Caroline B Prudencio  1 , Sthefanie K Nunes  1 , Luiz Takano  1 , Eusebio M A Enriquez  1 , Maiara I G Orlandi  1 , Baerbel Junginger  3 , Raghavendra L S Hallur  1 , Marilza V C Rudge  1 , Angélica M P Barbosa  1   4
Affiliations

Impact of gestational diabetes on pelvic floor: A prospective cohort study with three-dimensional ultrasound during two-time points in pregnancy

Carlos I Sartorão Filho et al. Neurourol Urodyn. 2020 Nov.

Abstract

Aim: To evaluate the pelvic floor (PF) biometry using three-dimensional ultrasound (US) at two-time points of gestational in pregnant women with gestational diabetes mellitus (GDM).

Methods: A prospective cohort study conducted at the Perinatal Diabetes Research Center including 44 pregnant women with GDM and 66 pregnant women without GDM at 24 to 28 weeks of gestation. Three-dimensional transperineal US was performed at 24 to 28 and 34 to 38 weeks of gestation in the lithotomy position at rest. The axial plane of the minimal Levator hiatal dimensions was used to determine Levator ani muscle and Hiatal area (HA) biometry at 24 to 28 and 34 to 38 weeks of gestation.

Results: Of the 110 pregnant women, 100 (90.9%) completed the follow-up at 34 to 38 weeks of gestation. The evaluation by US showed a negative biometric change between the two-time points, during pregnancy in women with GDM; in the HA (β coefficient: estimative of effect in biometric progression according to GDM diagnosis, using the non-GDM group as reference = -6.76; P = .020), anteroposterior diameter (β = -5.07; P = .019), and Levator ani thickness (β = -12.34; P = .005).

Conclusions: Pregnant women with GDM had a significantly lower than expected percentage of changes in biometry of Levator ani thickness and HA from 24 to 28 to 34 to 38 weeks of gestation when compared with the group of pregnant women without GDM. GDM alters the morphology of PF structures assessed by three-dimension US. This reported complication may be implicated in adverse birth outcomes and may play a role in the development of PF dysfunction.

Keywords: gestational diabetes mellitus; levator ani muscle; levator hiatus; pelvic floor; pregnancy; ultrasound.

PubMed Disclaimer

References

REFERENCES

    1. Dietz HP. Pelvic floor ultrasound: a review. Am J Obstet Gynecol. 2010;202(4):321-334. https://doi.org/10.1016/j.ajog.2009.08.018
    1. Tan L, Shek KL, Atan IK, Rojas RG, Dietz HP. The repeatability of sonographic measures of functional pelvic floor anatomy. Int Urogynecol J. 2015;26(11):1667-1672. https://doi.org/10.1007/s00192-015-2759-9
    1. van Veelen GA, Schweitzer KJ, van der Vaart CH. Ultrasound imaging of the pelvic floor: changes in anatomy during and after first pregnancy. Ultrasound Obstet Gynecol. 2014;44(4):476-480. https://doi.org/10.1002/uog.13301
    1. Association AD. 1. Improving care and promoting health in populations: standards of medical care in diabetes-2020. Diabetes Care. 2020;43(suppl 1):S7-S13. https://doi.org/10.2337/dc20-S001
    1. Barbosa AMP, Marini G, Piculo F, Rudge CVC, Calderon IMP, Rudge MVC. Prevalence of urinary incontinence and pelvic floor muscle dysfunction in primiparae two years after cesarean section: cross-sectional study. Sao Paulo Med J. 2013;131(2):95-99.

Publication types

LinkOut - more resources