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

• Published in: PloS one 2020-12, Vol.15 (12), p.e0241962-e0241962
• Main Authors: Barbosa, Angélica Mércia Pascon, Enriquez, Eusebio Mario Amador, Rodrigues, Meline Rossetto Kron, Prudencio, Caroline Baldini, Atallah, Álvaro Nagib, Reyes, David Rafael Abreu, Hallur, Raghavendra Lakshmana Shetty, Nunes, Sthefanie Kenickel, Pinheiro, Fabiane Affonso, Filho, Carlos Isaías Sartorão, Andrade, Gabriela Lopes Piemonte, Berghmans, Bary, Bie, Rob de, Lima, Silvana Andréa Molina, Rudge, Marilza Vieira Cunha
• Format: Article
• Language: English
• Subjects: Care and treatment; Clinical trials; Complications and side effects; Diabetes Complications - etiology; Diabetes Complications - physiopathology; Diabetes Complications - prevention & control; Diabetes Complications - rehabilitation; Diabetes mellitus; Diabetes mellitus (insulin dependent); Diabetes mellitus (non-insulin dependent); Diabetes, Gestational - rehabilitation; Electromyography; Exercise Therapy - methods; Female; Gestational diabetes; Gynecology; Health aspects; Humans; Hyperglycemia; Kegel exercises; Medical schools; Medicine and Health Sciences; Methods; Muscle strength; Muscles; Obstetrics; Patient outcomes; Pelvic floor; Pelvic Floor - physiopathology; Physical therapy; Physiological aspects; Postpartum; Pregnancy; Quality assessment; Quality control; Quality of Life; Questionnaires; Randomized Controlled Trials as Topic; Registered Report Protocol; Research and Analysis Methods; Reviews; Systematic Reviews as Topic; Training; Treatment Outcome; Urinary incontinence; Urinary Incontinence - etiology; Urinary Incontinence - physiopathology; Urinary Incontinence - prevention & control; Urinary Incontinence - rehabilitation
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241962

There 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. We 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. The 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. Systematic review registration: PROSPERO CRD42017065281.