Pregnancy

Question 1

What is the mission of the Program for Pregnancy and Postpartum Health?

Answer 1

To improve the life-long health of pregnant and postpartum individuals and their children

Question 2

How does physical activity impact the risk of diabetes and hypertension during pregnancy?

Answer 2

Physical activity is associated with an approximate 40% reduction in the risk of diabetes and hypertension during pregnancy

Question 3

What are the increased risks for a child if the mother has gestational diabetes or hypertensive disorders during pregnancy?

Answer 3

Increased risk of cardiovascular disease (CVD) and Type II diabetes

Question 4

How much can physical activity reduce the risk of depression in pregnant women?

Answer 4

Physical activity is associated with a 67% reduction in depression

Question 5

What were the 1985 ACOG guidelines regarding exercise during pregnancy?

Answer 5

No exercise above 140 bpm, based on expert opinion.

Question 6

What did the 1994 ACOG guidelines recommend about exercise during pregnancy?

Answer 6

They removed heart rate guidelines and recommended using “common sense”.

Question 7

What are the current (2019) Canadian guidelines for physical activity during pregnancy?

Answer 7

At least 150 minutes of moderate-intensity physical activity per week. Women wishing to be active at a vigorous intensity are encouraged to consult their obstetric care provider

Question 8

What types of physical activity are recommended during pregnancy according to the 2019 Canadian Guidelines?

Answer 8

A variety of aerobic and resistance training, plus daily pelvic floor exercises

Question 9

How much can following Canadian guidelines reduce the risk of pregnancy-related illnesses?

Answer 9

At least 25%

Question 10

How much can following Canadian guidelines reduce the odds of developing a major pregnancy complication (e.g., GDM, high blood pressure, pre-eclampsia)?

Answer 10

~ 40%

Question 11

What is the minimum professional requirement for a kinesiologist to work with a pregnant client?

Answer 11

CSEP CPT (Canadian Society for Exercise Physiology Certified Personal Trainer)

Question 12

List three metabolic adaptations that occur during pregnancy.

Answer 12

Increased insulin resistance, decreased glucose availability, increased resting VO2

Question 13

List three respiratory adaptations during pregnancy.

Answer 13

Increased resting ventilation, decreased arterial CO2, decreased bicarbonate, increased chemoreflex sensitivity.

Question 14

List three cardiovascular adaptations during pregnancy.

Answer 14

Increased heart rate, increased blood volume, increased stroke volume, increased cardiac output, decreased vascular resistance, equal or lower blood pressure.

Question 15

What percentage of females will become pregnant in their lifetime and what percentage will develop complications during pregnancy?

Answer 15

85% of females will become pregnant in their lifetime, and 20% of these will develop complications

Question 16

What pre-screening tools should be used before exercising with a pregnant client?

Answer 16

Get Active Questionnaire for Pregnancy (GAQ), Health Care Provider Consultation Form, Resting Heart Rate, Resting Blood Pressure, Glucose Considerations

Question 17

What are some absolute contraindications to exercise during pregnancy?

Answer 17

Ruptured membranes, premature labor, unexplained persistent vaginal bleeding, placenta praevia >28 weeks, preeclampsia, incompetent cervix, intrauterine growth restriction, high order multiples (triplets or higher), uncontrolled type 1 diabetes, hypertension, or thyroid disease

Question 18

What are some relative contraindications to exercise during pregnancy?

Answer 18

Recurrent pregnancy loss, history of spontaneous preterm birth (<37 weeks), gestational hypertension, symptomatic anemia, malnutrition, eating disorders, twin pregnancy after 28 weeks, mild/moderate cardiovascular or respiratory disease, other significant conditions

Question 19

What is the purpose of the Health Care Provider Consultation Form for Prenatal Physical Activity?

Answer 19

A communication tool between the pregnant individual, qualified exercise professional, and health care provider, identifying potential concerns, and allowing for modifications to physical activity

Question 20

What are the resting heart rate considerations during pregnancy?

Answer 20

• Resting heart rate peaks in the third trimester by 15-20 bpm higher than pre-pregnancy.
• If resting heart rate is <99 bpm, proceed with assessment. If heart rate is >100 bpm taken twice five minutes apart, refer to a physician.
• Recently, it has been recommended to raise the cutoff value to 120 bpm for pregnant individuals without contraindications

Question 21

What are the blood pressure considerations during pregnancy before exercise?

Answer 21

• There are no pregnancy-specific pre-exercise blood pressure cutoffs. A blood pressure of >140 mmHg systolic and >90 mmHg diastolic is the criteria for diagnosis of a hypertensive disorder during pregnancy.
• If blood pressure is >160 mmHg systolic OR >90 mmHg diastolic, taken twice five minutes apart, refer to a physician.

Question 22

What blood pressure reading after 20 weeks of gestation requires caution?

Answer 22

> 140/90 mmHg

Question 23

What glucose level should a pregnant individual have prior to exercise to avoid hypoglycemia?

Answer 23

At least 4.0 mmol/L

Question 24

What is the F.I.T.T. principle for exercise prescription?

Answer 24

Frequency, Intensity, Time, Type

Question 25

How many days per week should physical activity be accumulated to see a reduction in pregnancy complications?

Answer 25

A minimum of three days per week

Question 26

What is the recommended intensity of physical activity for pregnant women according to Canadian guidelines?

Answer 26

Moderate-intensity.

Question 27

How much activity should pregnant women accumulate each week?

Answer 27

At least 150 minutes.

Question 28

What types of exercise are recommended during pregnancy?

Answer 28

A variety of aerobic and resistance training

Question 29

What should be considered when choosing resistance training modalities during pregnancy?

Answer 29

Acknowledge prior experience and modify to accommodate the growing belly. Consider using wider bases of support or switching to non-weight bearing activities

Question 30

What are the recommendations for Olympic lifting during pregnancy?

Answer 30

Consider switching to kettlebells as gestation progresses due to increased risk of trauma to the growing belly and loss of technique

Question 31

What is the general moderate intensity on the Borg Scale?

Answer 31

Being able to talk but not sing during the activity.

Question 32

What is the general vigorous intensity on the Borg Scale?

Answer 32

Being unable to say more than a few words without pausing for a breath

Question 33

Why should supine exercises be modified during pregnancy?

Answer 33

Compression of the inferior vena cava can decrease venous return and cardiac output, resulting in symptomatic hypotension and possible non-reactive fetal heart rate.

Question 34

What is the hormone relaxin and what precautions should be taken during exercise due to it?

Answer 34

It is a hormone produced by the ovary and placenta that softens and relaxes ligaments. Caution with activities that are jarring or have quick turns and ensure adequate warm up and cool down. Relaxin is NOT associated with pain.

Question 35

What should be considered when exercising with a client with carpal tunnel syndrome?

Answer 35

Avoid activities that make symptoms worse, such as push-ups, planks, and heavy weight lifting. Modify by maintaining a neutral wrist position, decreasing the intensity, and consider stretching and icing to reduce inflammation. Refer to healthcare provider when symptoms first arise

Question 36

What is urinary incontinence and how can it be addressed?

Answer 36

Involuntary leakage of urine, affecting up to 75% of pregnant women. Pelvic floor muscle training may help to reduce the risk.

Question 37

What is diastasis recti and how can it be prevented?

Answer 37

Separation of the rectus abdominis muscle along the linea alba. It has a higher rate of occurrence in sedentary individuals

Question 38

What environmental factors should be avoided during physical activity?

Answer 38

Excessive heat and high humidity due to increased risk of fainting and dehydration. Also, avoid activities that risk trauma to the belly

Question 39

List activities that should be avoided during pregnancy.

Answer 39

Scuba diving, high altitudes, contact sports, downhill skiing, and riding a non-stationary bike

Question 40

What are the key considerations when training a previously inactive pregnant woman?

Answer 40

Progress slowly, monitor closely, remember that some exercise is better than none, and the intensity of an activity may change over the course of pregnancy

Question 41

When can exercise be resumed postpartum after vaginal delivery?

Answer 41

After bleeding stops.