Professional Documents
Culture Documents
Michael Zanovec
April 15, 2008
ACOG 1985:
Old • Limit HR to 140
• No vigorous
activity > 15
min
vs.
New
Research – Exercise and Pregnancy
• Aerobic fitness can be maintained throughout
pregnancy
• Women wishing to resistance train need to avoid
supine exercises
• No relationship demonstrated between activity
levels and birth weight
• No human studies have shown that hyperthermia
associated with exercise is teratogenic
• Fetal heart rate may transiently increase or
decrease with maximal exercise but no adverse
birth outcomes
• Anatomic changes may predispose to
musculoskeletal injury
Advising exercise during pregnancy:
Steps to beginning an exercise program
• Clinical Evaluation
▫ Routine prenatal care is sufficient for monitoring exercise
program
• Medical Screening before exercise
▫ Overall health, obstetric, and medical risks reviewed
▫ Physical limitations / contraindications – evaluate throughout
pregnancy
• Exercise prescription - physical activity plan
▫ Consideration should be given to patient’s goals, initial fitness
level, and to balance frequency, intensity, duration, and
type of exercise so that the risks do not exceed the benefits
▫ Additional attention should be given to progression in
intensity over time
Conditions requiring medical supervision
ABSOLUTE CONTRAINDICATIONS
• Cardiac disease
• Restrictive lung disease
• Persistent bleeding (2nd & 3rd trimester)
• Preeclampsia / PIH
• Preterm labor (previous/present)
• Cervical weakness
• Placenta previa after 26 wks
• Preterm pre-labor rupture of membranes
• Multiple gestation
Conditions requiring medical supervision
RELATIVE CONTRAINDICATIONS
• Severe anemia (Hb < 100 g/L)
• Intrauterine growth restriction
• Poorly controlled hypertension, diabetes, thyroid
disease, or seizures
• Unevaluated maternal cardiac arrythmia
• Chronic bronchitis
• Extremely sedentary lifestyle
• Morbid obesity (BMI > 40)
• Malnutrition or eating disorder (BMI < 12)
• Orthopedic limitations
• Heavy smoker
General Guidelines – Where to start?
• In the absence of either medical or obstetric complications, follow
the current CDC-ACSM guidelines (Artal & O’Toole, 2003).
• For general health and well-being, accumulate at least 30 minutes of
moderate-intensity aerobic and/or muscle-strengthening exercise at
least 5 days/week (Haskell et al., 2007).
▫ Moderate intensity = 3-5 METs (equivalent to brisk walking)
600
300
Water aerobics
Moderate intensity
Vacuuming (3-6 METs)
200 Walking, 3 mph
Cleaning house
Yoga
100 Typing Light intensity
(<3 METs)
Sitting quietly
0
Recommended Exercises During Pregnancy
• Avoid
▫ Scuba diving
• Poor Balance:
▫ Centre of gravity shifts as pregnancy
progresses
▫ Exercise cautiously
▫ Pay attention to changes to terrain