Pregnancy

Hypertension and protein in the urine during pregnancy are symptoms of what condition?

preeclampsia

Which hormone influences the corpus luteum in order for it to produce sex hormones?

hCG

____ is responsible for slowing down the passage of food through the intestines in order to enhance the delivery of nutrients to the fetus

progesterone

Which form of Spina Bifida is most severe?

Cystica

Vasoconstriction of blood vessels occurs during the early stages of pregnancy

false

After fertilization, during which week of gestation is central nervous system development at its greatest?

3rd

An expected change for a healthy pregnancy is that maternal insulin sensitivity ____, which allows for ____ glucose delivery to the fetus.

decreases; more

During which trimester do the greatest hormone fluctuations occur?

first

During the first weeks of pregnancy ____ has the largest influence on cardiac output, however, in late pregnancy, ____ has the largest effect

stroke volume; heart rate

How does the reduction in maternal insulin sensitivity that accompanies pregnancy assist with fetal development?

The reduction in maternal insulin sensitivity during pregnancy, (insulin resistance) helps ensure that more glucose remains in the maternal blood. This higher blood glucose level allows greater glucose delivery to the fetus, which is critical for fetal growth and brain development. Essentially, it prioritizes nutrient supply to the fetus even if the mothers’s tissues need more insulin to absorb glucose

What are the components of weight gain during pregnancy? How much does each component contribute to the total weight gain?

Average 30lbs gained during pregnancy.

• increase in breast size, 2lbs

• increase in mothers fluid, 4lbs

• placenta, 1.5lbs

• amniotic fluid, 2lbs

• infant at birth, 7.5lbs

• increase in size of uterus and supporting muscles, 2lbs

• increased blood volume, 4lbs

What are the principle symptoms of pre-eclampsia? Additional Symptoms? What is thought to be the cause for the onset of pre-eclampsia

• proteinuria and hypertension due to vasoconstriction

• other symptoms include: edema, rapid weight gain, low oxygen tissue extraction leading to low O2 consumption

• cause is thought to be the placenta implanting improperly in the lining of the uterus, preventing arteries from dilating as they should

Fetal and maternal risk associated with obesity during pregnancy?

• obese woman are at an increased risk of gestational diabetes and high blood pressure

• babies born to obese mothers are more likely to have heart defects and neural tube defects

What are the reasons for exercise to be terminated immediately? What are the absolute contraindications to exercise during pregnancy?

• Terminated immediately: vaginal bleeding, dizziness, dyspnea before exertion, chest pain

• Absolute: Hemodynamically significant heart disease, Restrictive lung disease, Incompetent cervix/cerclage, Multiple gestation at risk for premature labor, Persistent second or third trimester bleeding, Placenta previa after 26 wk of gestation, Premature labor during the current pregnancy, Ruptured membranes, Preeclampsia/pregnancy-induced hypertension

Provide and describe the 3 factors that facilitate the diffusion of oxygen from the placenta

1. fetal hemoglobin: higher O2 affinity than adult

2. partial pressure O2: higher in maternal blood

3. double bohr effect: increased CO2 concentration on maternal side causes Hgb to release oxygen (less affinity for O2, opposite effect on fetal side)

Describe how cardiac output changes throughout pregnancy. Be sure to describe how heart and SV change as well

• cardiac output: increases during first 8 months by 40-50%, placental circulation and increased BMR

• in the first weeks, SV is mainly responsible for increased cardiac output

• later, heart rate contributes more to cardiac output. left ventricular wall thickness and mass increase by 28 and 52%

Describe the fluctuations over time in hCG, estrogens, and progesterone during pregnancy

• hCG levels rise rapidly in the first trimester, then decline

• estrogen and progesterone levels steadily increase, with the placenta becoming the primary source after the first trimester

• progesterone levels peak in the third trimester

Provide the roles of hCG, estrogen, progesterone, and relaxin.

• hCG: maintains the corpus luteum

• Estrogen: proliferative function on most reproductive organs, rebuilds the endometrial lining after menstruation

• progesterone: increases secretions of fallopian tubes and uterus to provide nutritive environments for developing blastocyst

• relaxin: softens cervix at time of delivery

Why should a pregnant woman avoid supine exercises during late pregnancy? Specifically describe what anatomical and physiological changes occur.

• Because the enlarged uterus compresses the inferior vena cava, reducing venous return, cardiac output, and blood pressure.

• This can cause dizziness, fainting, and decreased blood flow to the fetus, so side-lying or upright positions are safer

How does aerobic exercise affect maternal weight and birth weight? Describe why it has this affect.

helps limit maternal weight gain and may slightly lower birth weight by improving metabolism, insulin sensitivity, and placental efficiency

What are the benefits of exercise for the cardiovascular system during pregnancy? How is this beneficial for the mother and fetus? What are some specific benefits for resistance training during pregnancy?

Exercise during pregnancy provides important cardiovascular benefits, including improved cardiac output, stroke volume efficiency, lower resting heart rate and blood pressure, and enhanced circulation. These changes benefit the mother by reducing fatigue, improving endurance, and lowering the risk of gestational hypertension or preeclampsia, while also supporting fetal growth and oxygen delivery through better placental blood flow. Resistance training adds further benefits by maintaining muscle strength and endurance, improving joint stability and posture, reducing low back pain, and helping regulate blood glucose, which can lower the risk of gestational diabetes.

What should be avoided during resistance training while pregnant

avoid exercises that require lying flat on the back in the second and third trimesters, heavy lifting or maximal effort that causes straining or breath-holding, and movements with a high risk of falling or abdominal trauma. Rapid, jerky, or ballistic exercises should also be avoided, as well as exercising in conditions that could cause overheating or dehydration. Safe modifications and controlled movements help protect both mother and fetus

Critical periods during gestation

Critical periods during gestation are specific times when developing organs and tissues are most sensitive to environmental influences. During these periods, exposure to harmful factors like drugs, alcohol, infections, or nutritional deficiencies can cause structural malformations or functional deficits. The first trimester, especially weeks 3–8, is the most critical for organogenesis, when major organs are forming. Later in pregnancy, the fetus is more vulnerable to factors that affect growth and functional development rather than causing major structural defects

ACSM recommendations for all types of exercise during pregnancy.

• The ACSM recommends that pregnant women engage in at least 150 minutes per week of moderate-intensity aerobic exercise, spread throughout the week,

• perform resistance training 2–3 days per week with moderate weights or body weight, 8–15 repetitions per set, targeting major muscle groups.

• Flexibility exercises should be gentle, avoiding overstretching due to increased ligament laxity. Exercises should be moderate in intensity (able to talk comfortably), avoid supine positions after the first trimester, and prevent overheating or dehydration.

• Exercise should be stopped if warning signs occur, such as vaginal bleeding, dizziness, chest pain, contractions, fluid leakage, or decreased fetal movement.

Birth weight of babies tend to be greater in pregnant exercisers compared to non-exercising pregnant women.

false

Compared to pre-pregnant levels, which of the following would be expected to remain the same or decrease during aerobic exercise in a pregnant woman?

systolic blood pressure

When using the Borg rating of perceived exertion scale, which value corresponds to moderate intensity?

12

During pregnancy, which of the following is NOT a reason to terminate exercise immediately and follow-up with a physician?

increased blood pressure

It is MOST important to avoid strenuous exercise during the ____ trimester

first

Based on most recommendations, how many minutes per week of moderate-intensity aerobic exercise (not including warm-ups) should a pregnant women strive for?

150

Being a heavy smoker is a (n) ________________ contraindication for exercise during pregnancy.

relative

Which exercise should be avoided by a pregnant woman in her 3rd trimester?

Lying dumbbell bench press

For resistance training, how many repetitions would be most appropriate for a pregnant woman?

12