PLoS ONE (Jan 2020)

Effectiveness of the pelvic floor muscle training on muscular dysfunction and pregnancy specific urinary incontinence in pregnant women with gestational diabetes mellitus: A systematic review protocol.

  • Angélica Mércia Pascon Barbosa,
  • Eusebio Mario Amador Enriquez,
  • Meline Rossetto Kron Rodrigues,
  • Caroline Baldini Prudencio,
  • Álvaro Nagib Atallah,
  • David Rafael Abreu Reyes,
  • Raghavendra Lakshmana Shetty Hallur,
  • Sthefanie Kenickel Nunes,
  • Fabiane Affonso Pinheiro,
  • Carlos Isaías Sartorão Filho,
  • Gabriela Lopes Piemonte Andrade,
  • Bary Berghmans,
  • Rob de Bie,
  • Silvana Andréa Molina Lima,
  • Marilza Vieira Cunha Rudge,
  • Diamater Study Group

DOI
https://doi.org/10.1371/journal.pone.0241962
Journal volume & issue
Vol. 15, no. 12
p. e0241962

Abstract

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BackgroundThere is ample evidence that gestational diabetes mellitus has a direct influence on urinary incontinence and pelvic floor muscles. There are no standardized pelvic floor muscle exercise programs in the literature for the physiotherapy and differ in the type of exercise, intensity, type and duration of application, and the frequency and duration of treatment sessions. The aim of this systematic review will be to investigate that Pelvic Floor Muscle Training can prevent and/or decrease the pregnancy specific urinary incontinence in women with gestational diabetes mellitus or gestational hyperglycemia.MethodsWe will perform a systematic review according to the Cochrane methodology of Randomized Controlled Trials. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases, with the date of consultation until June 2020. The MeSH terms used will be "Pregnancy", "Hyperglycemia", "Diabetes Mellitus, Type 2", "Diabetes Mellitus, Type 1", "Pregnancy in Diabetics", "Diabetes, Gestational", "Urinary Incontinence", "Pelvic Floor Muscle Strength". Primary outcomes: improvement or cure of pregnancy specific urinary incontinence (which can be assessed by questionnaires, and tools such as tampon test, voiding diary, urodynamic study). Secondary outcomes: improvement of pelvic floor muscle strength (pelvic floor functional assessment, perineometer, electromyography, functional ultrasonography), improved quality of life (questionnaires), presence or absence of postpartum Urinary Incontinence and adverse effects. Quality assessment by Cochrane instrument. Metanalysis if plausible, will be performed by the software Review Manager 5.3.DiscussionThe present study will be the first to analyze the effectiveness of pelvic floor exercises in pregnant women with Gestational Diabetes Mellitus or Hyperglycemia, who suffer from pregnancy specific urinary incontinence. Randomized Controlled Trials design will be chosen because they present the highest level of evidence. It is expected to obtain robust and conclusive evidence to support clinical practice, in addition to promoting studies on the theme and contributing to new studies.Trial registrationSystematic review registration: PROSPERO CRD42017065281.