Lecture 8 - Exercise and Pregnancy Flashcards
What is Preeclampsia?
A potentially dangerous pregnancy complication characterised by high blood pressure.
What are the metabolic effects of pregnancy?
Weight gain (10-14 kg; most in 3rd trimester)
– Increased nutrition required ~ 1200kJ/day after 1st trimester
What are some musculoskeletal effects of pregnancy
LB px, • Lordosis and back pain occur in ~ 50% of women late in pregnancy – Increase in ligament laxity due to relaxin
What are some respiratory considerations and effects of pregnancy?
• Respiratory changes - increased VE (minute ventilation)
– Can limit exercise in latter stages
What are some CV changes during pregnancy
CV changes - are progressive:
– Increase blood volume, HR, SV, CO
– Decrease in MAP ~ 5-10 mmHg mid- pregnancy; returns to normal in latter stages of pregnancy
– Supine or prolonged standing may decrease VR (vena cava compression)
– Increased level of thrombin and decrease in anticoagulant factors as well as an increase in blood volume and estrogen levels can lead to an increased risk of blood clots
Describe what happens to pregnant women and the disposition to blood clots
– Increased level of thrombin and decrease in anticoagulant factors as well as an increase in blood volume and estrogen levels can lead to an increased risk of blood clots
What are some considerations for pregnant women during exercise?
a) thermoregulation, b) risks to foetus, c) urinary incontinance
What are some absolute contraindications for pregnant women and exercise?
Placenta previa
Premature labor
Ruptured membranes
Preeclampsia
Incompetent cervix
Multiple gestation at risk for premature labor
Persistent second- or third-trimester bleeding
Placental abruption
Hemodynamically significant heart disease
Restrictive lung disease
What are some relative contraindications for pregnant women and exercise?
Severe anemia
Malnutrition or eating disorder
Thyroid disease not under control
Orthopedic limitations
History of heavy smoking
Morbid obesity
Poorly controlled hypertension
Poorly controlled seizure disorder
Poorly controlled hyperthyroidism
Intrauterine growth restriction
Poorly controlled type 1 diabetes
Bacterial infection requiring antibiotic therapy
Other significant medical conditions not mentioned above
What are the warning signs to stop exercise for pregnant women?
Vaginal bleeding, regular painful contractions, amniotic fluid leakage, dyspnea before exertion, dizzyness, headaches, chest pain, muscle weakness affecting balance, calf pain or swelling
What is recommended before pregnant women start exercise if they have no history of regular exercise?
– Check with Dr prior to commencing program
– Generally recommend lower to moderate intensity aerobic exercise
– 30 min daily at 3-5 METS
– Don’t try to obtain substantial fitness gains
– Don’t use exercise for large weight loss (unless medically recommended & supervised)
– Use exercise to stabilise weight & maintain fitness
Are we aiming to improve fitness during pregnancy?
If exercised prior to pregnancy
– Generally OK to continue training
– Usual aim is to maintain fitness not improve
What are 4 activities not recommended during pregnancy?
- Activities with an increased risk of trauma, 2. Activities with physiological risk factors, 3. Activities involving lying in supine positions after the first trimester, 4. Activities pregnant women who are not already active should avoid
What are the aerobic recommendations during pregnancy?
Large muscle group dynamic activity, 30 min/day Low-Moderate intensity (& 20-60 min 3-5 x/week if Vig-High intensity), RPE of 11-13 often recommended, exercise is not progressive
Is heart rate reliable for monitoring exertion during pregnancy?
No
