Women's Health Flashcards
Nulligravida =
never been pregnant
Primigravida
Pregnant for the first time/one time
risks associated with low weight gain during pregnancy
preterm birth
risks with overweight/high weight gain during pregnancy
High BP - pre-eclampsia gestastional diabetes large baby c-section birth defect difficulty losing weight post natal
List 6 MSK changes that happen during pregnancy
Increase Lx lordosis and Cx protraction, downward mvt of shoulder, change COG
stretching, weakness, separation of abs
joint laxity - ant/post longitudinal ligs
Widening of SIJ and PS
increased pelvic anterior tilt , increased use of hip extensors/abductors and ankle PF
widened stance to maintain trunk movement
Risk factors for developing lumbar pain
pre-existing LBP, hx LBP
Prev. Pelvis trauma
conflicting evidence : occupational, multiparity, hypermobility, obesity
What causes lumbar pain in pregnancy
altered posture, muscle weakness, joint laxity, z-jt irritation, fluid retention
Risk factors for developing pelvic girdle/SIJ pain
multigravida, hx LBP, stress, obesity, young age, occupational, SE status, C section
Objective measures
pain worse on WB, prolonged sitting, SLS
SIJ provocation tests +ve
Symphysis pubis pain may be caused by
increased joint mobility; insidious or traumatic
normal widening during pregnancy is 9-10mm
Symptoms of symphysis pubis pain
joint may click or clunk
local anterior pain, pain on WB, leg separation, SLS
Usually resolves 4-12 wks PP
Treatment for symphysis pubis
Rest, education/advice, walking aids
(crutches/walking frame)
pelvic support braces
stabilising exercises
Advice for PSP/PGP/LPP
try
- pillows between legs when sleeping
- Keep legs together when getting out of the bed/car
avoid - uneven weight distribution - bending/ lifting/carrying weights Reduce stride length Avoid leg separation avoid crossing legs
List 7 benefits of exercising during pregnancy
improved maternal physical fitness, PF function Improved physical/mental wellbeing Decreased back and pelvic pain maternal weight control Fewer delivery complications decr. risk of elevated BP/pre-eclampsia Reduced risk of gestational diabetes (?)
potential risks while exercising pregnant
hyperthermia - avoid hot weather, dehydration
Risk of falls - due to COG/weight changes
Risk abdominal injury - low risk
increase joint laxity - injury risk
Effect on birth weight
- enhanced birth weight
- severe exercise for longer= lighter babies
More frequent exercise in 3rd tri=lower birth weight
Non-Exercisers lighter babies than moderate ex
Aerobic Exercise guidelines during pregnancy
healthy women can begin/maintain moderate intensity aerobic exercise
No study has found negative effect on foetus / pregnancy
swimming, running, aerobics, cycling = safe
Safe upper limit uncertain
avoid excess stretching, ballistic movements
No effect on course or outcome of labour
Associated with fewer brith interventions
Resistance exercise guidelines during pregnancy
recommended 2 x/w submax intensity
light-mod training with free weights, machines, bands, body weight or combo
Recommendation : light to moderate weights, avoid heavy max isometric contractions
- avoid valsalva, supervise safe technique
- avoid supine position 2nd/3rd trimester
No obvious effects on weight gain, pregnancy complications, course of labour, birth weight (Clapp)
When to stop exercising
abdominal pain uterine contraction, labour, bleeding gush of fluid/amniotic fluid leakage calf pain or swelling chest pain/tightness/palpitations decreased foetal movements Dizziness or presyncope dyspnoea pre exertion, excessive SOB Excessive fatigue, muscle weakness Pelvic pain Headache
Absolute contraindications to exercise include
significant cardiac disease restrictive lung disease Cervix insufficiency Multiple gestations (>triplets) Placental abruption placenta previa after 28th week Premature labour during current pregnancy Ruptured foetal membrane, foetal growth restriction Persistant 2nd/3rd trimester bleeding preeclampsia, gestational hypertension
precautions to exercise while pregnant include
severe anaemia HB<100g/L
Twin pregnancy >28th week
mild-moderate CV/resp disorder
poorly controlled type 1 diabetes
Primary hypertension
Poorly controlled seizure disorder or thyroid disease
Extreme obesity, malnutrition, eating disorder (BMI<12)
Previous miscarriage, previous preterm birth
Hx of extremely sedentary lifestyle
Heavy smoking
List 8 birth injuries
forceps - sacral/pubic ligament injury
large birth weight >4000g, 3rd/4th tears, forceps / ventouse - diastasis pubis
bleeding into SIJ - sacroilitis
Pressure on coccyx - post partum back pain
Separation of linea alba - rectus diastasis >1-2cm
Perineal tears
prolapse
First degree perineal tear
tear
second degree perineal tear
perineal muscles (torn)
Third degree perineal tear
anal sphincter torn
perineal muscles torn
