Pregnancy and Exercise

Pregnancy changes

• cardiopulmonary

• anteriorly displaced centre of gravity
• hormone - jt and ligt laxity
• oedema - compression neuropathy
• bone metabolism - ?osteoporotic/osteonecrotic

Exercise benefits

• Psychological - depression, fatigue
• Biological - blood pressure (pre-eclampsia), ?gestitational DM, easier vaginal delivery (less C-section, less prolonged labour), weight (less gain, faster loss)

Guidelines:

• active - yes
• sedentary - yes
• Contraindication - (placenta previa, imcompetent cervix, preexlampsia, PPROM, antepartum haemorrhage, IUGR, abruptio, multiple gestation)

Regime: (220 - age ) x 60-80% = target heart rate

pregnancy NOT reach peak fitness
<70% maximal aerobic power
maximal exertion impairs fetal heart rate (unconfirmed relationship with fetal outcome) -  placental setal syndrome and transient fetal bradycardia

non-wt bearing sport
cycling and swimming
swimming better: hydrostatic pressure decreased oedema (increase uterine perfusion); less injury chance; diuresis decreased oedema (unknown cause)

Drugs:
NSAID - cardiac (septal defect, premature closure of ductus arterosis)
COX2 inhibitor - renal
Steroids - potential of cleft lip (relationship weak)

oral acetaminophen