Perinatal Maternal Exercise

Posted by e-Medical PPT Friday, March 23, 2012
Objective
To  explain the impact of exercise on maternal,fetal, and neonatal conditions.

Conservative Recommendations (ACOG 1985)
1) For exercising women:to reduce the habitual levels of exercise during  pregnancy .
2) For non-exercising women:to refrain from initiating exercise  .

Rationale For Conservative Recommendations
1)Exercise could affect early and late pregnancy outcomes by:
Increasing core body temperature during embryogenesis Increasing the risk of congenital anomalies.

Shifting oxygenated blood and energy  to maternal skeletal muscle away from the developing fetus disturbances in growth.

2) Risk of maternal  musculoskeletal injury due to:
Changes in posture and centre of gravity.
3) Fetoplacental injury due to blunt  trauma or stress from sudden motions.

Recent Investigations(ACOG)&(SOGC)&( CSEP_)(EBM)2003
1) Both aerobic and strength-conditioning exercise in pregnancy, not lead to increase in:
Early pregnancy loss
 Late pregnancy complications
Abnormal fetal growth
Adverse neonatal outcomes.

2) Risks of non  practicing exercise  during pregnancy:
 loss of muscular and cardiovascular fitness.
Excessive maternal weight gain
Gestational diabetes
 pregnancy-induced hypertension
Development of varicose veins
Deep vein thrombosis.

2) Risks of non  practicing exercise  during pregnancy: cont…
Higher incidence of physical complaints:-
Dyspnea
Low back pain,
Poor psychological adjustment to the physical changes of pregnancy.

3) Benefits Of Exercise During Pregnancy:
Minimize minor discomfort associated with the pregnancy.
 Improve posture.
 Make the body more supple,
 Enhance circulation.

Assist  expulsion of fetus  during delivery
Provide a feeling of general well-being.
Strengthen the muscles  stressed by pregnancy—(abdominal, low back and Pelvic floor).

Absolute Contraindications
PIH
Preterm rupture of membranes
Threatened preterm labor
Incompetent cervix
Persistent second- trimester bleeding
Placenta previa.
Intrauterine growth restriction

Relative contraindications
Chronic hypertension
Thyroid  dysfunction
Cardiac disease
Vascular disease
Pulmonary disease
Multiple pregnancy..

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