pregnancy

Question 1

how much weight does someone gain during pregnancy?

Answer 1

20-30lbs essential for baby’s nourishment

Question 2

MSK postural changes

Answer 2

forward head, thoracic kyphosis, lumbar lordosis, APT
postural stress continue postpartum due to lifting and carrying baby
- pelvic floor mm drop
decrease in lig tensile strength (hypermobility) due to hormones

Question 3

how does BP change during pregnancy

Answer 3

BP decreases during 1st and 2nd trimester, and increases during 3rd
due to venous distensivility

Question 4

How does CO change during pregnancy

Answer 4

increases

Question 5

How does HR change during pregnancy

Answer 5

Resting HR Increases 10-20bpm.
Does not proportionally increase with exercise

Question 6

What happens with supine lying?

Answer 6

• after 1st trimester
• compresses IVC, decreases CO
• can lead to supine hypotensive syndrome

Question 7

What does left sidelying do

Answer 7

-decreases compression of IVC, maximimize CO, decrease GERD, increase maternal and fetal circulation, internal organs are more relaxed

Question 8

Pulmonary changes

Answer 8

depth of respiration increase
RR unchanged
work of breathing increase
TV increase but TLC stays same/decrease
subcostal angle inrease - ribs flare up and out
diaphragm slightly elevated, changed by rib position

Question 9

thermoregulatory system changes

Answer 9

metabolism inc
heat production inc
fasting BG decrease because need to feed fetus

Question 10

cardio changes

Answer 10

blood volumes increase
venous pressure in LE increases in standing
increased pressure in IVC (can lead to hypotensive syndrome) which is why want to lay in L sidelying)
heart size increases

Question 10

gestational diabetes

Answer 10

increased BG during this time ONLY because body doesnt make enough insulin

Question 11

ectopic pregnancy

Answer 11

egg is fertilized outside uterus, not safe and can result in termination
can complain of back pain
emergency

Question 12

Pre-eclampsia

Answer 12

pregnancy induced hypertension after 20th week of gestation
EMERGECY
increase in protein in urine, hyperreflexia, edema, blurry vision, headache and sudden weight gain
BP >140/90. Second abnormal BP reading 4 hrs after first confirms the diagnosis

Question 13

eclampsia

Answer 13

Soor after birth or during delivery
Same symptoms as pre-eclampsia but with seizures

Question 14

pregnancy contraindications to exercise

Answer 14

• premature labor before 37wks
• placenta previa (very low)
• uncontrolled type 1 diabetes
• severe anemia
• pre-eclampsia/pregnancy induced hypertension
• hemodynamically significant heart disease
• restrictive lung disease
• incompetent cervix: early dilation of cervic
• vaginal bleeding
• rupture of membranes - loss of amniotic fluid before onset of labor

Question 15

what are levels of anemia?

Answer 15

moderate: Hgb: 8-10 g/dL
severe: Hgb 6.5-7.9 g/dL
life threatening: Hgb less than 6.5 g/dL

Question 16

should you exercise patient with gestational diabetes?

Answer 16

YES

Question 17

what is diastasis recti

Answer 17

split of rectus abdominus at linea alba

Question 18

test for diastasis recti

Answer 18

3rd day post-partum
test: pt in hooklying, ask them to do curl up so scapulae clear ground. Place fingers over linea alba
significant if >2cm

Question 19

severity of diastasis recti and treatments

Answer 19

<2cm: PPT, pelvic clocks, with stabilizing
2-4cm: brace pelvic by crossing hands over abdomen, head lifts
(can progress to brace+head lifts+PPT)
>4cm: brace abs+breathing exs
>6cm: refer to Dr. for surgery