GUest Lecture on Preg Flashcards
Influences 2 possibly three generations
Hypertensive disorders of pregnancy is about 3 times risk of chronic hypertension
gestational diabetes have about a 7 times risk of type 2 diabetes and hypertensive disorders of preg and gestational diabetes incresed risk of CVD nd type 2 diabtets in the child
PA have about a 40 percent reduction in diabetes and hypertension in preg and a 67 percent reduction in depression also imporves long term cardiovascula and metabolic health o f the child
History
prior 85 no guidelines 85 not above 140 bpm 94 took away 03 first canadian guidelines
current guidelines
150 mins moderate intensity aerobic and resistence training
benefits in preg pa
40% reduction in pregancy complications 24% refduction in instrumental devlity
What is the min requirement to deal with preg
CCEP CPt but there is a specialization for pregancy specific considerations you have to get
Pregency
Period of rapid and profound change where virtually every physiological system in the body is affected impact PA during pregancy first tri is 1-13 second is 14- 27 third is 28-40 baby is considered done at 37
Adaptations during a normal pregnancy 3 sections
Metabolic - incresed insulin resistence (too much leads to gastrointestional diabetes) lowered glucose availibility for mom and incresed resting VO@
Cardiovascular - incresed HR incresed blood vol incresed strok vol incresed cardiac output decresed vascular resistence if this does not occur BP will go up equal or lower bp
REspiratory - incresed resting ventilation decresed artial co2 torr
decresed bicarbonate incresed chemoreflext sensitivity HCVR HVR
Not all preg progress smoothly
85% of females get preg 20 % will dveleop complicatoins that will negatively impact current and future health
Pre screeening for exercise preg
GAQ pg 1 - contraindications absolute and relative
Absolute contraindications GAQ def and 9 things
Moderate to vig exercise shoul dbe avoided however ADLs may be continued as directed by the health care prof
Ruptured membrane or prematreure labour
unexplained persistent vaginal bleeding
placenta prawvia more than 28 weeks
preclampsia incresed bp
incompetend cervic or cervical insufficieny - less likley to keep in baby
intrauterine growth restriction smol baby
high order mulitples truiplets or larger
unocntrolled type 1 diabetes hypertension or thyroid disease other serioud cardiovascular respiriratory or systemic disorders
Relative contraindications to exercise def and 9 things
Speak with health care professional to discuss pros and cons of exercise is approriate consider scaled back intensity duration and volume
Recurrent loss in a row and very common on ein four
history of spontanoues preterm birth less then 37 weeks
gestational hypertension
symptonatic anaemia
malnutrition
eating disorders
twin preg after 28 weeks
mild moderate cardiovascualr or respiratory disease
other significant consitions
GAQ for preg page.2
assesment of current PA levels general aduce for PA during preg declaration if answer no to all questions on pg 1 continnue if they answer yes to one or more consult helath care prac if prac says no do not continue do not have the scope of practise to go over the head
Referrals
Communuication tool between prg qualified exercise professiona and health care provider identify potential concerns opportunity for health care providers to suggest modications to PA document is updtaed when there is a change in health
Resting HR preg
peaks in 3rd tri by 15-20 bpm 29% of women with over 30 bmi in theird tri go into sinus tachycardia
Rasied cut off to 120 bpm which also lowers the barrier to PA in preg
Resting bp
no preg speicific pre exercise bp cut offs but over 140 over 90 is criteria for hypertensive disorder for preg