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Exercise and Pregnancy. What are the common responses and adaptations we see in the pregnant exerciser?. Cardiovascular system:. Cardiac output rapid increase in 1st two trimesters levels off in 3rd 30-50% above normal increased stroke volume greater strain on heart during exercise.

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exercise and pregnancy
Exercise and Pregnancy

What are the common responses and adaptations we see in the pregnant exerciser?

cardiovascular system
Cardiovascular system:
  • Cardiac output
    • rapid increase in 1st two trimesters
    • levels off in 3rd
    • 30-50% above normal
    • increased stroke volume
    • greater strain on heart during exercise
cardiovascular system1
Cardiovascular system:
  • Blood flow distribution
    • increased flow to surface
    • increased renal, pulmonary, and uterine blood flow
    • decreased total peripheral resistance and increased peripheral blood flow
    • decreased venous return
    • exercise helps with venous return
cardiovascular system2
Cardiovascular system:
  • Blood pressure
    • decreased SBP and DBP during 1st two trimesters
cardiovascular system3
Cardiovascular system:
  • Blood volume
    • increases 50% by end of 2nd trimester
    • increased plasma volume
pulmonary system
Pulmonary System
  • Diaphragm elevates
    • FRC decreases by 25% due to decreased ERV and RV
    • hyperventilation occurs at rest due to increased progesterone levels and changes in the threshold of the respiratory centers.
metabolic system
Metabolic System:
  • Slight increase in blood acidosis
  • Increase in resting VO2 and VCO2
metabolic system1
Metabolic System:
  • Metabolic rate is increased
  • Increased use of carbohydrates as fuel
  • result
    • increased VO2 at any given workload
    • increased O2 debt (EPOC)
musculoskeletal system
Musculoskeletal System:
  • Increased joint laxity (relaxin)
  • Stretching and thinning of abdominal wall
musculoskeletal system1
Musculoskeletal System:
  • Forward shift in c of g and anterior rotation of pelvis
  • Proprioception and coordination are adversely effected
benefits of exercise to the pregnant woman
Benefits of Exercise to the Pregnant Woman
  • 1. Facilitate a general feeling of well-being.
  • 2. Control of body composition.
  • 3. Maintenance or development of optimal posture.
  • 4. Decrease in the minor discomforts of pregnancy.
  • 5. Promotes pelvic floor strength.
benefits of exercise to the pregnant woman1
Benefits of Exercise to the Pregnant Woman
  • 6. Maintain or improve aerobic conditioning.
  • 7. Maintain or improve strength and/or flexibility.
  • 8. Facilitate general recovery after delivery.
    • Decrease by 1/2 post partum recovery days.
  • 9. Improved tolerance during delivery.
benefits of exercise to the pregnant woman2
Benefits of Exercise to the Pregnant Woman
  • 10. Improved physiologic adaptations to pregnancy.
  • 11. Improved ability to dissipate heat.
  • 12. Limits the pregnancy related increase in peripheral insulin resistance.
risks to the mother
Risks to the Mother:
  • 1. Risks of injury due to overuse.
  • 2. Increased potential for fatigue.
  • 3. Joint injury.
  • 4. Redistribution of cardiac output.
  • 5. Thermoregulatory problems.
latest research
Latest Research
  • Most women increase body mass by 20% during pregnancy.
latest research1
Latest Research
  • Supine exercise doesn’t create abdominal hernias.
    • Abdominal recover within 6 weeks.
latest research2
Latest Research
  • Cardiac remodeling occurs.
    • VO2 Max higher 10-40 weeks post-partum.
latest research3
Latest Research
  • Birth occurs 5-7 days earlier.
    • No increased incidence of premature birth.
latest research4
Latest Research
  • Higher rate of normal delivery.
    • Quicker recovery post-partum.
latest research5
Latest Research
  • Decreased feelings of stress.
latest research6
Latest Research
  • Increased fitness and muscle tone.
latest research7
Latest Research
  • Improved bladder control.
risks to the baby
Risks to the Baby:

A. Heat Stress:

  • 1. Heat stress and malformation (animal studies).
  • 2. Heat stress and malformation in saunas in humans during early pregnancy.
risks to the baby1
Risks to the Baby:
  • 3. With exercise there is an increase in skin temperature with minor increases in core temperature.
  • 4. Exercising studies have not shown the correlation between heat stress and malformation.
risks to the baby2
Risks to the Baby:

B. Oxygen Delivery:

  • 1. Animal studies show conflicting results.
  • 2. Body can adapt to make-up for decreased blood flow - increase hemoconcentration and better extraction.
risks to the baby3
Risks to the Baby:

C. Fetal Heart Rate Changes:

  • 1. Conflicting results.
  • 2. Increased HR during start of exercise then it levels off.
risks to the baby4
Risks to the Baby:
  • 3. No adverse effects.
  • 4. Trained women show less uterine blood flow.
risks to the baby5
Risks to the Baby:

D. Decreased Blood Flow:

  • 1. Animals suggest there is a relationship between exercise and low birth weight.
risks to the baby6
Risks to the Baby:
  • 2. This does not seem to be a problem in rationally trained women.
  • 3. No relationship between exercise and miscarriage.
guidelines for exercise
Guidelines for Exercise
  • 1. Medical and exercise history of the individual.
  • 2. Questions or unusual symptoms
    • bleeding, dizziness,
    • cramping, joint pain
    • faintness, elevated blood pressure,
    • STOP exercising and consult physician.
guidelines for exercise1
Guidelines for Exercise
  • 3. Listen to your body.
  • 4. Expect some discomfort.
guidelines for exercise2
Guidelines for Exercise
  • 5. Exercise regularly.
  • 6. Do not exercise vigorously in hot humid weather.
guidelines for exercise3
Guidelines for Exercise
  • 7. Do not exercise at all during an illness with fever.
guidelines for exercise4
Guidelines for Exercise
  • 8. Avoid high impact activities.
  • 9. Drink plenty of fluids.
guidelines for exercise5
Guidelines for Exercise
  • 10. Rise slowly from down positions.
  • 11. ACOG recommends that the HR not exceed 140 bpm.
guidelines for exercise6
Guidelines for Exercise
  • 12. Avoid the valsalva maneuver.
guidelines for exercise7
Guidelines for Exercise
  • 13. Do not begin a new fitness program.
  • 14. Follow basic fitness principles.