Tuesday, August 10, 2010

Contraindications for Exercise in Pregnancy

American College of Obstetricians and Gynecologists

The American College of Obstetricians and Gynecologists (ACOG) has stated that for most women, exercise during pregnancy is healthy. However, they do advise that each pregnancy be evaluated individually to determine the safety to mother and baby.
                                                  
According to ACOG, there are cases in which it is not safe for the mother to participate in aerobic exercise. The mother is recommended not to exercise if she has:
  • Haemodynamically significant heart disease
  • Restrictive lung disease
  • Incompetent cervix/cerclage
  • Multiple gestation at risk for premature labor
  • Persistent second or third trimester bleeding
  • Placenta praevia after 26 weeks gestation
  • Premature labor during the current pregnancy
  • Ruptured membranes
  • Pregnancy induced hypertension
ACOG also feels that in some instances, aerobic exercise may not be safe. Pregnancies should be reviewed carefully if the mother has:
  • Severe anemia
  • Unevaluated maternal cardiac arrhythmia
  • Chronic bronchitis
  • Poorly controlled type I diabetes
  • Extreme morbid obesity
  • Extreme underweight (body mass index < 12)
  • History of extremely sedentary lifestyle
  • Intrauterine growth restriction in current pregnancy
  • Poorly controlled hypertension/pre-eclampsia
  • Orthopaedic limitations
  • Poorly controlled seizure disorder
  • Poorly controlled thyroid disease
  • Heavy smoker
According to ACOG, a pregnant woman should cease exercising and contact her health care provider if she experiences:
  • Vaginal bleeding
  • Dyspnoea before exertion
  • Headache
  • Chest pain
  • Muscle weakness
  • Calf pain or swelling (need to rule out thrombophlebitis)
  • Preterm labor
  • Decreased fetal movement
  • Amniotic fluid leakage

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