The Effect of Gestational Diabetes Mellitus on the Pelvic Floor-A Two-Dimensional Gray-Scale Histogram Study.

Purpose: This study aimed to analyze the effect of gestational diabetes mellitus (GDM) on the mean echogenicity of the puborectalis muscle (MEP).

Methods: This prospective case-control study included pregnant women who applied to the antenatal clinic between February 2023 and April 2024. Pregnant women complicated by gestational diabetes constituted the GDM group. Patients not diagnosed with gestational diabetes were included in the Control group. MEP assessment and progress from 24th to 36th weeks of gestation were analyzed by the two-dimensional volumetric gray-scale histograms.

Results: A total of 130 pregnant women, 30 in the Insulin-use group, 49 in the Diet-regulated group, and 51 in the Control group. MEP values in the GDM group were significantly higher at the third trimester at rest and on maximum pelvic floor muscle contraction than those in the Control group. Twenty-fourth to 36th weeks MEP rest difference and 24th-36th weeks MEP contraction difference were significantly higher in the GDM group than those in the Control group.

Conclusions: Measuring echogenicity may help us understand what happens in the pelvic floor muscles after pregnancy complicated by GDM. We need to evaluate the pelvic floor more rationally using ultrasound in patients with gestational diabetes and be alert to possible pelvic floor damage.