Women's Health Flashcards
Nulligravida =
never been pregnant
Primigravida
Pregnant for the first time/one time
risks associated with low weight gain during pregnancy
preterm birth
risks with overweight/high weight gain during pregnancy
High BP - pre-eclampsia gestastional diabetes large baby c-section birth defect difficulty losing weight post natal
List 6 MSK changes that happen during pregnancy
Increase Lx lordosis and Cx protraction, downward mvt of shoulder, change COG
stretching, weakness, separation of abs
joint laxity - ant/post longitudinal ligs
Widening of SIJ and PS
increased pelvic anterior tilt , increased use of hip extensors/abductors and ankle PF
widened stance to maintain trunk movement
Risk factors for developing lumbar pain
pre-existing LBP, hx LBP
Prev. Pelvis trauma
conflicting evidence : occupational, multiparity, hypermobility, obesity
What causes lumbar pain in pregnancy
altered posture, muscle weakness, joint laxity, z-jt irritation, fluid retention
Risk factors for developing pelvic girdle/SIJ pain
multigravida, hx LBP, stress, obesity, young age, occupational, SE status, C section
Objective measures
pain worse on WB, prolonged sitting, SLS
SIJ provocation tests +ve
Symphysis pubis pain may be caused by
increased joint mobility; insidious or traumatic
normal widening during pregnancy is 9-10mm
Symptoms of symphysis pubis pain
joint may click or clunk
local anterior pain, pain on WB, leg separation, SLS
Usually resolves 4-12 wks PP
Treatment for symphysis pubis
Rest, education/advice, walking aids
(crutches/walking frame)
pelvic support braces
stabilising exercises
Advice for PSP/PGP/LPP
try
- pillows between legs when sleeping
- Keep legs together when getting out of the bed/car
avoid - uneven weight distribution - bending/ lifting/carrying weights Reduce stride length Avoid leg separation avoid crossing legs
List 7 benefits of exercising during pregnancy
improved maternal physical fitness, PF function Improved physical/mental wellbeing Decreased back and pelvic pain maternal weight control Fewer delivery complications decr. risk of elevated BP/pre-eclampsia Reduced risk of gestational diabetes (?)
potential risks while exercising pregnant
hyperthermia - avoid hot weather, dehydration
Risk of falls - due to COG/weight changes
Risk abdominal injury - low risk
increase joint laxity - injury risk
Effect on birth weight
- enhanced birth weight
- severe exercise for longer= lighter babies
More frequent exercise in 3rd tri=lower birth weight
Non-Exercisers lighter babies than moderate ex
Aerobic Exercise guidelines during pregnancy
healthy women can begin/maintain moderate intensity aerobic exercise
No study has found negative effect on foetus / pregnancy
swimming, running, aerobics, cycling = safe
Safe upper limit uncertain
avoid excess stretching, ballistic movements
No effect on course or outcome of labour
Associated with fewer brith interventions
Resistance exercise guidelines during pregnancy
recommended 2 x/w submax intensity
light-mod training with free weights, machines, bands, body weight or combo
Recommendation : light to moderate weights, avoid heavy max isometric contractions
- avoid valsalva, supervise safe technique
- avoid supine position 2nd/3rd trimester
No obvious effects on weight gain, pregnancy complications, course of labour, birth weight (Clapp)
When to stop exercising
abdominal pain uterine contraction, labour, bleeding gush of fluid/amniotic fluid leakage calf pain or swelling chest pain/tightness/palpitations decreased foetal movements Dizziness or presyncope dyspnoea pre exertion, excessive SOB Excessive fatigue, muscle weakness Pelvic pain Headache
