Ante-natal education Flashcards
contraindications of exercise in pregnant women
Placenta previa after 26/40
Incompetent cervix
Multiple gestation at risk for premature labour
Persistent bleeding in 2nd-3rd trimester
Premature labour during the current pregnancy
Preterm rupture of membranes
Pre-eclampsia
Pregnancy-induced Hypertension
relative contraindications for exercise in pregnant women
Severe anaemia
* Unevaluated maternal cardiac
arrhythmia
* Chronic bronchitis
* Malnutrition/ Eating disorder
* Morbid Obesity (BMI>40)
* Poorly controlled Diabetes
Mellitus
how is gestational diabetes diagnosed
Diagnosed when blood sugars are higher than normal in pregnancy by
glucose tolerance test (GTT) at 27/40
what are the possible complications in gestational diabetes
Can result in babies with heavier birth weight and increased risk of
diabetes and obesity
how is a gestational diabtes diagnosis tested
patient fasts for 24 hours is given a sugary drink to consume afterwards and blood glucose levels are tested
positive impact of exercise in gestational diabetes
lowers blood glucose levels - inc. insulin sensitivity
manage symptoms
may help prevent gestational diabetes in future pregnancy and onset of T2DM
pelvic girdle pain definition
pain experienced between
the posterior iliac crest and the gluteal fold, particularly in the
vicinity of the sacroiliac joints (SIJ). The pain may radiate in the
posterior thigh and can also occur in conjunction with/or
separately in the symphysis. (Vleeming et al, 2008)
describe epidemiology of pelvic girdle pain amongst pregnant women
20%
describe epidemiology of low back pain amongst pregnant women
50%
what functional difficulties are pregnant women with low back pain expected to have
getting up from a sitting
position, turning over in bed, prolonged sitting, prolonged
walking, dressing/undressing and lifting and carrying small
weights.
treatment plan for pelvic girdle pain
Education on nature of PGP
Inform and reassure
Postural advice
Movement strategy advice
Individualized exercise programme
Manual therapy
Supports
function of pelvic floor
Prevent incontinence
Support pelvic organs and weight
of baby and prevent prolapse
Allow bladder and bowel emptying
Length and stretch for delivery
Sexual function
Part of core muscles supporting
pelvis and low back
describe frequency of pelvic floor muscle exercises
10 long hold
10 quick
3 times a day
what are good habits to adapt for a healthy bladder
1.5-2 litre fluid intake throughout the day. Limit caffeine or other
bladder irritants
Voiding every 3-4 hours, sit rather than hover
what are good habits to adapt for a healthy bowel
Balanced diet, fibre, avoiding straining, correct toileting position
and pushing technique
at what gestation period can early pregnancy class be offered
18-24 wks
what is offered in an early pregnancy class
18-24 weeks gestation
* Promotion of exercise and guidelines for same
* Pelvic floor exercises
* Good bladder and bowel habits
* Back care, posture and ergonomics
* Coping strategies for minor discomforts
* Referral pathway for specific problems
what is the content in labour classes
exposes your mani concerns about labour and opens a discussion on labour
review of labour - signs and stages
strategies for 1st stage of labour
2nd stage
postnatal recovery
baby’s physical development
1st stage labour
from when contractions start til baby is pushed put
uterine contraction to form pathway for baby to come out
cervix thins and dilates
lasts 12 hours on average
want the pregnant person to stay at home for most of early stage labour to increase oxytocin levels
techniques to manage contractions
breathing - breathe for 2 seconds and breathe out for 4 seconds
rubbing - rubbing muscle fibres of glutes
rocking - helping to stretch and open birth canal to 30%
rest - sight out at the end of each contraction
ice/heat
upright position
transition stage
between end of first stage and beginning of 2nd stage
contractions closer together
can last up to an hour
describe 2nd stage of labour
cervix fully dilated and ends with delivery of baby
last 2 hrs
upright gravity assisted positions
normal lumbar spine curve
chin tucked not flexed
PGP
What is a peanut ball and how does it help
ball oval or peanut shape placed between legs to open pelvis and promoted dynamic position to assist the baby to move done vaginal canal
can be used in 1st and 2nd stage
can be used in conjunction with epidural
how does the flexed position of the lumbar spine affect birth canal rectus abdominus and pelvic floor
curves birth canal and
closes pelvic floor, encourages separation of rectus
abdominus muscles
recommended pushing technique during 2nd stage of labour
Widen the waist and brace the abdomen out
Breathe out as you push
Push as if emptying bowels
Keep open glottis and make a noise, “mooing”
Keep abdomen braced and repeat
Avoid holding breath for entire push
disadvantages of purple pushing
dec. mother’s BP => reduced placental blood flow
infant HR slows => hypoxia
mother - exhausted, stressed, lactic acid build up
non reassuring foetal heart rate patterns
inc. risk of dvt
Inc risk of forceps
pelvic floor nerve and muscle damage
benefits of perineal massage
reduce perineal trauma and need for episiotomy among primiparous women during childbirth
dosage of perineal massage
daily from week 34 of pregnancy, 10 mins per day
how should perineal massage be conducted
before session - empty bladder, wash hands, after bath, use mirror position for comfort use mirror
lubrication with natural oil
massage vaginal wall in u shape movement stretch and hold
integrate PF exercise
post natal recovery
explanation of role in women’s health physio post natal
bed mobility
circulatory exercises
DRAM management
PF exercises
healthy bladder habits
Abdominal exercises
Specific advice after C section
