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Rudge MVC, Souza FP, Abbade JF, Hallur RLS, Marcondes JPC, Piculo F, Marini G, Vesentini G, Thabane L, Witkin SS, Calderon IMP, Barbosa AMP, Rudge MV, Barbosa AMP, Calderon IMP, Souza FP, Abbade JF, Hallur LSR, Piculo F, Marini G, Vesentini G, Thabane L, Palma MS, Graeff CFO, Arni RK, Herculano RD, Salvadori DF, Mateus S, Dal Pai Silva M, Magalhães CG, Costa RA, Lima SAM, Felisbino SL, Barbosa W, Atallah A, Girão MJB, Di Bella Z, Uchoa SM, Payão S, Hijas A, Berghman B, De Bie R, Sobrevia L, Junginger B, Alves FCB, Rossignoli PS, Prudencio CB, Orlandi MIG, Gonçalves MI, Nunes SK, Catinelli BB, Quiroz S, Sarmento BV, Pinheiro FA, Sartorão CI, Lucas RR, Reyes DRA, Quiroz SBCV, Enriquez EMA, Oliveira RG, Floriano JF, Marcondes JPC, Barneze S, Dangió TD, Pascon T, Rossignoli P, Freitas JV, Takano L, Reis F, Caldeirão TD, Fernandes JN, Carr AM, Gaitero MVC, Corrente JE, Nunes HRC, Candido AF, Costa SMB, Dangió TD, Pascon T, Melo JVF, Takano L, Reis FVDS, Caldeirão TD, Carr AM, Garcia GA, Rabadan GB, Bassin HCM, Suyama KS, Damasceno LN, Takemoto MLS, Menezes MD, Bussaneli DG, Nogueira VKC, Lima PR, Lourenço IO, Marostica de Sá J, Megid RA, Caruso IP, Rasmussen LT, Prata GM, Piculo F, Vesentini G, Arantes MA, Ferraz GAR, Camargo LP, Kron MR, Corrente JE, Nunes HRC. Study protocol to investigate biomolecular muscle profile as predictors of long-term urinary incontinence in women with gestational diabetes mellitus. BMC Pregnancy Childbirth 2020; 20:117. [PMID: 32075598 PMCID: PMC7031907 DOI: 10.1186/s12884-020-2749-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/RAM hyperglycemic myopathy will be evaluated. METHODS The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. DISCUSSION To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.
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Affiliation(s)
- Marilza V C Rudge
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.
| | - Fátima P Souza
- Physics Department, Institute of Biosciences, Letters and Exact Sciences, Multiuser Center for Biomolecular Innovation, UNESP-São Paulo State University, Sao Paulo, Brazil
| | - Joelcio F Abbade
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Raghavendra L S Hallur
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - João Paulo C Marcondes
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Fernanda Piculo
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.,Physiotherapy Department, Faculdades Integradas de Bauru, FIB, Sao Paulo, Brazil
| | - Gabriela Marini
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.,Universidade do Sagrado Coração (USC), Jardim Brasil, Bauru, Sao Paulo, Brazil
| | - Giovana Vesentini
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.,Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare-Hamilton, Hamilton, ON, Canada
| | - Steven S Witkin
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.,Institute of Tropical Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Iracema M P Calderon
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil
| | - Angélica M P Barbosa
- Department of Gynecology and Obstetrics, Botucatu Medical School (FMB), São Paulo State University (UNESP), CEP18618-687, Sao Paulo, Brazil.,School of Philosophy and Sciences, Department of Physiotherapy and Occupational Therapy, UNESP-São Paulo State University, Marília, Sao Paulo, Brazil
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Peraçoli JC, Rudge MV, Sartori MS, da Silva Franco RJ. Effects of hypertension on maternal adaptations to pregnancy: experimental study on spontaneously hypertensive rats. SAO PAULO MED J 2001; 119:54-8. [PMID: 11276166 DOI: 10.1590/s1516-31802001000200003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
CONTEXT Animal models for essential hypertension have been used for understanding the human pathological conditions observed in pregnant hypertensive women. OBJECTIVE To study the possible effects of pregnancy on hypertension and of hypertension on pregnancy in spontaneously hypertensive rats (SHR), and in their normotensive Wistar-Kyoto (WKY) counterparts. TYPE OF STUDY Comparative study using laboratory animals. SETTING Animal Research Laboratory of Clinical Medicine at the Medical School of Botucatu, São Paulo State University, Brazil. SAMPLE Ten to twelve-week-old virgin female normotensive Wistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR). The animals were separated into four groups: 15 pregnant spontaneously hypertensive rats (SHR-P), 10 non-pregnant spontaneously hypertensive rats (SHR-NP), 15 pregnant normotensive rats (WKY-P), and 10 non-pregnant normotensive rats (WKY-NP). MAIN MEASUREMENTS The blood pressure was evaluated by the tail cuff method, in rats either with or without prior training for the handling necessary for tail cuff measurements. The maternal volume expansion was indirectly evaluated by weight gain, and by systemic parameters as hematocrit, hemoglobin, total protein, albumin and sodium retention. The perinatal outcome of pregnancy was evaluated by analysis of resorptions, litter size, rate of low weight and number of stillbirths. RESULTS The late fall in blood pressure in the pregnant SHR strain and in the normotensive WKY strain can only be detected in rats previously trained to accept the handling necessary for the tail cuff measurement. During pregnancy the body weight gain was significantly higher in WKY than in SHR rats. Systemic parameters were significantly lower in pregnant WKY rats than in non-pregnant WKY rats, while no differences were observed between pregnant and non-pregnant SHR groups. In pregnant WKY rats the sodium retention was higher from the 13th day onwards, while in SHR rats this occurred only on the 21st day. The characteristics of reproductive function such as number and weight of fetus, perinatal mortality and the resorption rate were significantly affected in the SHR strain. CONCLUSION The SHR strain may be considered as a model for chronic hypovolemic maternal hypertension, with the fetal growth retardation being determined by this hypovolemic state.
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Affiliation(s)
- J C Peraçoli
- Department of Gynecology and Obstetrics, Faculty of Medicine of Botucatu, State University of São Paulo, Botucatu, Brazil.
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