Exercise and Pregnancy

Chapter 86 Exercise and Pregnancy




Clinical Case Problem 1: A 34-Year-Old Primigravida Aerobic Dance Instructor


A 34-year-old aerobic dance instructor sees you for advice about her pregnancy. She is 6   weeks pregnant and wonders if she should continue her current work. Her work consists of 3 or 4 hours of exercise daily. She currently has no problems performing this activity but wonders if all the “bouncing and stepping” will cause a miscarriage or otherwise harm the baby.



Select the best answer to the following questions




1. Regarding her current physical activity, you tell her which of the following?


a. any exercise during pregnancy is not advisable

b. aerobic and strength training exercises are likely to increase her chance of miscarriage

c. the pregnancy-associated physiologic changes in her body make dance aerobics inadvisable

d. continuing moderate exercise during pregnancy is desirable and not harmful

e. she should decrease to 30 minutes of exercise a day to prevent intrauterine growth restriction (IUGR)

2. Which of the following is an absolute contraindication to exercise during pregnancy?


a. a history of incompetent cervix or cerclage

b. a history of a sedentary lifestyle

c. poorly controlled type 1 diabetes

d. a heavy smoker

e. morbid obesity

3. Which of the following is correct concerning cardiovascular changes during pregnancy?


a. after the first trimester, the supine position results in relative obstruction of venous return, decreased cardiac output, and orthostatic hypotension

b. motionless standing is associated with an increase in cardiac output during pregnancy

c. core temperatures during exercise increase 2 degrees more than in nonpregnant women

d. heart rate decreases with exercise in pregnancy

e. exertion at altitudes higher than 2500 feet cause significant cardiac compromise in pregnant women


Clinical Case Problem 2: A 37-Year-Old Pregnant Woman with Severe Back Pain


A 37-year-old pregnant woman comes to your office with low back pain that has been getting worse as her pregnancy has progressed. This is her third pregnancy; the previous two were uncomplicated except for chronic back pain, and this one has also been without any other difficulty. She has tried bed rest, acetaminophen, and heat pads—all without relief. She has no symptoms of dysuria or sensory-motor complaints; she says she is willing to try anything for relief. Examination is that of a normal early third-trimester pregnancy.



4. Regarding her chronic pregnancy-related back pain, you state the following:


a. step aerobics should be of therapeutic value in relieving the pain

b. water aerobics has been shown to relieve back pain in pregnant women

c. therapeutic massage is of no value in her condition

d. stationary bicycling should help her discomfort

e. bed rest is best

5. Your patient decides to try water aerobics, and her symptoms improve. Her mother-in-law, however, has told her that swimming is harmful to the baby. She seeks your advice. You tell her


a. water immersion late in pregnancy is often complicated by an increased rate of urinary tract infections

b. water immersion late in pregnancy is often complicated by an increase in vaginal discharges

c. water immersion late in pregnancy is dangerous because of the possibility of inducing an amnionitis

d. water immersion late in pregnancy is associated with preterm onset of labor

e. water immersion late in pregnancy is safe


Clinical Case Problem 3: A 22-Year-Old Primigravida with Recent Onset of Abdominal Tightness while Exercising on the Treadmill


A 22-year-old primigravida in her second trimester returns to your office saying that she had an episode of abdominal tightness that occurred while exercising on her treadmill. Normally, she power walks for 20 minutes each day. She had failed to drink water, as she normally does before and during exercise, and after she rested and drank two bottles of water, her symptoms resolved. Evaluation included a normal nonstress test result with minimal uterine irritability that resolved after another liter of oral rehydration and a normal hemoglobin level. She asks when she can resume her exercise activity.



6. Reasons to discontinue exercise include all of the following except


a. preterm labor

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Oct 1, 2016 | Posted by in GENERAL SURGERY | Comments Off on Exercise and Pregnancy

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