General Obstetrics and Gynecology: Obstetrics
Exercise-related changes in umbilical and uterine artery waveforms as assessed by Doppler ultrasound scans,☆☆

https://doi.org/10.1067/mob.2002.125741Get rights and content

Abstract

Objective: The purpose of this study was to assess the effect of strenuous symptom-limited exercise on umbilical and uterine blood flow. Study Design: Twenty-two primiparous women between 30 and 34 weeks of gestation were recruited. At rest, umbilical and uterine artery waveforms were assessed by measuring the pulsatility index. This was followed by a symptom-limited incremental exercise test. Fetal umbilical and maternal uterine artery circulations were assessed after exercise. Results: Strenuous maternal exercise was demonstrated by the significant change in physiologic parameters, which was associated with an immediate increase in fetal heart rate, a significant increase in the right uterine artery pulsatility index, and a reduction in the umbilical artery pulsatility index. Conclusion: The modest change in the uterine artery pulsatility index without an adverse change in the umbilical artery pulsatility index indicates that a single bout of maximum symptom-limited exercise does not have immediate adverse fetal or maternal cardiovascular effects. (Am J Obstet Gynecol 2002;187:661-6.)

Section snippets

Methods

This study was carried out with 22 nonsmoking primiparous women from 30 to 34 weeks of gestation (as confirmed by a first trimester dating scan) with uneventful pregnancies to date. This group is a subgroup of a larger study that is looking at the effects of exercise in pregnancy. These women had a low level of fitness, as classified by Artal et al,4 who were mainly sedentary with only occasional episodes of exercise and with jobs that were mainly sedentary with minimal physical effort. All

Results

In all 22 women were recruited. The maternal characteristics are presented in Table I.

. Maternal characteristics (n = 22)

CharacteristicMean ± SD
Age (y)25.9 ± 4.9
Height (cm)163.4 ± 7.0
Weight (kg)72.2 ± 11.7
Gestation (wk)32.1 ± 1.4
Body mass index (kg/m2)26.9 ± 3.8
Economic group3.6 ± 1.3
Calorie day−1 (kcal)2375 ± 578
The principal results are shown in Tables II and III.Table II shows that a strenuous level of exercise was achieved, with significant rises in oxygen uptake, and that an average of 86%

Comment

Several previous studies, with the use of different methods, have looked at the effect of maternal exercise on umbilical artery waveforms with differing results.14, 15, 16, 17 The methods of these studies have varied greatly. The significance of most of these studies is limited as quantification of stress in the exercise test (load or duration) or objective quantification in physiologic terms (percent of maximum oxygen consumption or heart rate) was not detailed. A number of these studies used

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    Reprint requests: Mairead M. Kennelly, MRCOG, Research Department, Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Square, Dublin, Ireland.

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