pregnancy Flashcards

Question

how does exercise help pre-ecpampsia

Answer 1

Reduced levels of C-reactive protein - C reactive protein stops endothelium producing NO, thus less vasodilation Increased nitric oxide production by endothelium = vasodilation Decreased Leptin

Answer 2

Leptin may contribute to hypertension because of its role in stimulating the body to burn fat. Leptin stimulates SNS activity to burn fat – but this increases blood pressure and lead to hypertension

Answer 3

Increased plasma progesterone (a smooth muscle relaxant) + increased uterine size constipation slowing of gastrointestinal motility relaxation of the lower oesophageal sphincter, which leads to increased gastric reflux ie: heartburn

Answer 4

Anterior displacement of the enlarging uterus changes the woman's - centre of gravity - exaggerates normal lumbar lordosis ↑ in hormone levels (especially progesterone, but also relaxin) - promotes ligament and joint laxity - Pelvic area susceptible The enlarging breasts - centre of gravity moves inferiorly and anteriorly - increased weight can contribute to upper back and shoulder pain

Answer 5

``` Average weight gain ≅ 12 kg • fetus 3.5kg • Uterus 1.0 kg • Placenta 0.6kg • Amniotic fluid 0.8kg • Breast enlargement 1.5kg • Maternal fluid gain 2.0kg • Maternal fat 2.5kg ```

Answer 6

changes to placenta blood flow foetal tachycardia foetal bradycardia foetal hyperthemia

Answer 7

changes in uteroplacental blood flow the flow of blood through the placenta remains unchanged, but the flow of blood to the pregnant uterus is reduced, as it is for any organ during exercise. Foetal oxygen supply not compromised or slightly reduced - Compensatory increased placental a-vo2 difference (Baby extracts more) Return to normal (or even higher temporarily) after 20 minutes of stopping

Answer 8

``` >160bpm Foetal HR + 10-30 beats during exercise Reduced blood flow? Response to circulating maternal catecholamines during exercise Increased maternal core temperature ```

Answer 9

<120bmp Response to hypoxia, to reduce foetal O2 demands Is seen mostly in long-duration exercise and / or post-exercise

Answer 10

Foetal temp is about 5 °(F) higher than maternal temp – thus baby loses heat via this gradient Could increased maternal temp during exercise reduce heat gradient, plus reduced uterine blood flow meaning less blood is available to remove heat, cause foetal hyperthermia and damage? No evidence for this as increased sweating, enhanced peripheral vasodilation helps to cool mother’s core temp.

Answer 11

Findings have been inconsistent Feotoplacental growth higher in active mothers Feotoplacental growth lower in active mothers Birth weight appears unaffected in women who maintain adequate energy balance (diet = exercise) Mothers who continue to perform a high volume of exercise in mid to late pregnancy, have thinner + lighter babies (200-400g less)

Answer 12

The concern is that increased norepinephrine and prostaglandin output during exercise could stimulate uterine activity and premature labour. No real supportive evidence to confirm this

Answer 13

Haemodynamically significant heart disease Restrictive lung disease Incompetent cervix Known risk of premature labour Persistent 2nd or 3rd Trimester bleeding Placenta previa after 26 weeks Premature labour during current pregnancy Ruptured membranes Preeclampsia Severe anaemia

Answer 14

``` Severe anaemia Unevaluated maternal cardiac dysrhythmias Chronic bronchitis Poorly control type 1 diabetes Extreme morbid obesity Extreme underweight (BMI <12) History of extremely sedentary lifestyle Intrauterine growth restriction Poorly controlled hypertension Orthopaedic limitations Poorly controlled seizures Poorly controlled hyperthyroidism Heavy smoker ```

Answer 15

``` Excessive shortness of breath Chest pain or palpitations Presyncope or dizziness Painful uterine contractions or preterm labour Leakage of amniotic fluid Vaginal bleeding Excessive fatigue Abdominal pain, particularly in back or pubic area Pelvic girdle pain Reduced foetal movement Dyspnoea before exertion Headache Muscle weakness Calf pain or swelling ```

Answer 16

``` preventing hyperthermia - adequate hydration - wear appropriate clothing - environment not to hot or cold temp should not excedd 37.8 ```

Answer 17

low risk pregnancy - moderate exercise 30-30 mins on most days aim towards 150 MVPA participation in team sports for first 15 weeks

Answer 18

weigth supported - O2 cost is the same weight bearing - increase in VO2, cost proportional to weigth higher HR, SV, VE and Q compared to non preg

Answer 19

reduced liver glycogen stores reduced sympathoadrenal activation reduces catecholamin production reducing delivery of CHO to muscles foetal dmenad for CHO takes priority

Answer 20

``` 3+ days a week low impact - cycling, walking 20-30 minute sessions Hr 120-160, 40-60-90% HRmax RPE 13-14 ```

Answer 21

for women already doing, can continue light to mod loads, 12-15 reps avoid exercise using valsalvas manoeuvre in 3rd trimester abdominal conditionimg in 1st and 2nd

Answer 22

stretches - not to max ROM nothing that requires great balance due to chnage in CoG low impact get up slowly - BP

Answer 23

1st - 100 2nd - 300 3rd -450

Answer 24

mininmal research evidence | hypothetically - higher VO2 should allow female to cope better with O2 demand of labour

Answer 25

walking, plevic floor exercises and stretching may begin immediately

Answer 26

caesarean - medical caregiver consulted first, usually at 6-8 week check up

Answer 27

may help reverse weight gained during pregnancy most weight loss occurs in 1st 3 months no increased weight loss be exercising and breastfeeding due to increase EI

Answer 28

peak VO2 increased by 10-25% BMD naturally declines in lactating women improved insulin sensivivity improves body image, psychological well being