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KIN 335 > Exercise and Pregnancy > Flashcards

Exercise and Pregnancy Flashcards

1
Q

What are some endocrine changes with pregnancy?

A
  • Gonadotropin
  • Progesterone
  • Estrogens
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2
Q

What are some cardiovascular system changes during pregnancy?

A
  • Uterine Blood Flow
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3
Q

What are some renal changes during pregnancy?

A
  • Renal Blood Flow
  • Glomerular Filtration Rate
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4
Q

What are some Respiration and Acid-Base Balances during pregnancy?

A
  • Increased VE
  • Reduced PaCO2/Respiratory Alkalosis
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5
Q

What does increased estrogen during pregnancy do?

A
  • Decreased peripheral vascular resistance
  • Decreased mean arterial pressure
  • Activation of the Renin-Angiotensin-Aldosterone System
  • Na+ Retention
  • Decreased Na+H2O
  • Decreased Osmolatity
  • Increased Blood Volume
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6
Q

What does increased Estrogen and progesterone during pregnancy lead to?

A
  • Increased drive to breathe
  • Increased Ventilation
  • Decreased PCO2
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7
Q

What does a decreased osmotic threshold for this and AVP release lead to in pregnancy?

A
  • H2O retention
  • Decreased Na+H2O
  • Decreased Osmolality
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8
Q

What changes occur to Autonomic control in pregnancy?

A
  • Altered skeletal muscle blood flow
  • Increased Burst Incidence
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9
Q

Describe the Cardiovagal Baroreflex Gain in pregnacy

A

Baroreflex control of cardiovascular system reset:
- Reset Downward in pregnant women
- Favoring shorter R-R intervals
- No significant change to SBP

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10
Q

Describe the central ventilatory chemoreflex in pregnancy

A
  • Response to hyperoxic hypercapnia in late pregnancy
  • Increase in subthreshold VE
  • Decrease central chemoreflex ventilatory recruitment threshold for CO2
  • Increase in central chemoreflex sensitivity
  • Chemical control of breathing altered
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11
Q

Describe the increase in progesterone and estrogen effect on ventilatory control

A
  • Increase in CNS progesterone receptors
  • Increase Neutral drive to breathe
  • Increase in pulmonary ventilation
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12
Q

What does the increase in pulmonary ventilation caused by the increase in estrogen and progesterone in pregnancy do?

A

Decreased
- H+ Blood
- Brain ECF
- Threshold of Chemoreflex
Increased
- Sensitivity of Chemoreflex

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13
Q

What is the hypothesis of ventilatory control during human pregnancy?

A

Increased Progesterone and Estrogen
- Increase CNS Progesterone Receptor
- Increased Neutral drive to breathe
- Increase ventilation
- Increase PaO2 / Decrease PaCO2
- Decreased H+ blood / Brain ECF
- Decrease threshold / increase sensitivity of central & peripheral chemoreflex response to CO2
- Increased ventilation

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14
Q

What does the mother transport and exchange with the fetus during pregnancy?

A
  • Glucose
  • Nutrients
  • Substrates
  • Hormone Precursors
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15
Q

What does the Fetus exchange and transport with the mother during pregnancy?

A
  • Waste Products (CO2, Heat, and Metabolic Byproducts)
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16
Q

What is affected the most by the increased metabolic demands for exercise?

A
  • The cardiovascular system
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17
Q

What is a major factor for the cardiovascular system being affected by the metabolic demand of exercise?

A
  • The Dissipation of the excess heat generated by exercise
18
Q

What happens to heat production during pregnancy? Why?

A

Increases
- Basal metabolic rate increases

19
Q

What is directly related to the increase in body temperature during exercise?

A
  • The exercise intensity
20
Q

How fast does the core temperature of non-pregnant women rise during moderate-intensity exercise?

A
  • 1.5C during first 30 minutes
  • Plateau’s after another 30 mins
21
Q

What is critical to heat balance?

A
  • Maintenance of euhydration
  • Maintenance of blood volume
22
Q

How does the cardiovascular system aid in heat balance?

A
  • Conductance of heat from core to periphery
23
Q

What happens during very high-intensity exercise in regards to heat?

A
  • Core temperature continues to rise
24
Q

What did a 1.5C rise in core temperature during embryogenesis in animal studies cause?

A
  • Major congenital malformations
25
Q

What did human studies on hyperthermia during pregnancy suggest?

A
  • Excess of 39C during first 45-60 days of gestation may be teratogenic in humans.
26
Q

What is teratogenic?

A
  • Disruption of the development of the embryo or fetus
27
Q

During pregnancy, under what conditions should exercise not be conducted?

A
  • Hemodynamically significant heart disease
  • Restrictive lung disease
  • Incompetent Cervix
  • Multiple gestation at risk for premature labour
  • Persistent second or third trimester bleeding
  • Placenta praevia after 26 weeks gestation
  • Premature labour during current pregnancy
  • Ruptured membranes
  • Pregnancy induced hypertension
28
Q

During pregnancy, under what conditions should exercise be conducted cautiously?

A
  • Severe Anaemia
  • Unevaluated maternal cardiac arrhythmia
  • Chronic Bronchitis
  • Poorly controlled type 1 diabetes
  • Extreme morbid obesity
  • Extreme underweight
  • History of extremely sedentary lifestyle
  • Intrauterine growth restriction in current pregnancy
  • Poorly controlled hypertension / pre-eclampsia
  • Orthopaedic limitations
  • Poorly controlled seizure disorder
  • Poorly controlled thyroid disease
  • Heavy Smoker
29
Q

What are some warning signs of terminating exercise while pregnant?

A
  • Vaginal Bleeding
  • Dyspnoea Before Exertion
  • Dizziness
  • Headache
  • Chest Pain
  • Muscle Weakness
  • Calf Pain or Swelling (thrombophlebitis)
  • Preterm Labour
  • Decreased Fetal Movement
  • Amniotic Fluid Leakage
30
Q

What are some hypothetical risks of exercising while pregnant?

A
  • Blood flow to the uterus leading to fetal hypoxia
  • Fetal hyperthermia
  • Reduced carbohydrate availability to the fetus
  • Possibility of miscarriage
31
Q

Potential risk of aerobic exercise for the mother during pregnancy?

A
  • Acute hypoglycemia
  • Chronic Fatigue
  • Musculoskeletal Injury
32
Q

What are the possible benefits of aerobic exercise for the mother during pregnancy?

A
  • Increased Energy Level
  • Reduced CV Stress
  • Prevention of Excessive Weight Gain
  • Facilitation of Labour
  • Faster Recovery from Labour
  • Prevention of Lower Back Pain
  • Prevention of Gestational Diabetes
33
Q

What are some hypothetical risks of aerobic exercise for the fetus?

A
  • Acute hypoxia
  • Acute hyperthermia
  • Reduced Glucose Availability
  • Miscarriage in 1st trimester
  • Premature Labour
  • Altered Fetal Development
  • Shortened Gestation
  • Reduced Birth Weight
34
Q

What are the possible benefits of aerobic exercise for the fetus?

A
  • Fewer complications of a difficult labor
35
Q

What are the current guidelines for physical activity during pregnancy?

A
  • 150min/wk
  • > 30 mins exercise on most days if not all days
36
Q

What are the guidelines for physical activity during pregnancy based on?

A
  • Improved maternal-fetal health outcomes
  • Reduced risk of gestational diabetes
  • Caesarean sections
  • Large for gestational age babies
37
Q

What are the altitude recommendations for physical activity during pregnancy?

A
  • 1800m for lowlanders
38
Q

Why are there guidelines for restricting physical activity at altitudes for pregnant individuals?

A
  • Critical reductions in oxygen delivery to the fetus
  • increased maternal oxygen demand
39
Q

What are the current deficits in understanding about physical activity at altitude for pregnant women?

A
  • Physical activity patterns in pregnant women living at altitude
  • Physiological responses in pregnant women to physical activity in mountainous regions.
  • The linkages between physical activity patterns and pregnancy outcomes in active high-altitude natives.
40
Q

What did the case study of Amber Miller identify?

A
  • It is possible to complete a marathon at this pace and deliver a baby on the same day.

KIN 335 (14 decks)

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