Pregnancy Advanced Sports Medicine 4134 Dr. Paulo Sanzo November 30, 2012 Jeff Ploen Jeff Ploen...

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Transcript of Pregnancy Advanced Sports Medicine 4134 Dr. Paulo Sanzo November 30, 2012 Jeff Ploen Jeff Ploen...

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Pregnancy Advanced Sports Medicine 4134 Dr. Paulo Sanzo November 30, 2012 Jeff Ploen Jeff Ploen Jessica French Jessica French Jen Wright Jen Wright Ben MacKay Ben MacKay Slide 2 Pregnancy Slide 3 First, Slide 4 Then, Slide 5 And THEN Slide 6 General Overview of Nine Months of Pregnancy From Conception to Birth Slide 7 The First Trimester Lasts from conception to the twelfth week of pregnancy 3 periods during the first trimester: 3 periods during the first trimester: The Germinal Period The Germinal Period Fertilized egg travels and implants in wall of uterus Fertilized egg travels and implants in wall of uterus Implantation occurs 10-14 days after conception Implantation occurs 10-14 days after conception The Period of the Embryo The Period of the Embryo Lasts from third through eighth week of pregnancy Lasts from third through eighth week of pregnancy Major organs and anatomical structures begin to form Major organs and anatomical structures begin to form The Period of the Fetus The Period of the Fetus Lasts from ninth week of pregnancy until birth Lasts from ninth week of pregnancy until birth All major organs continue rapid growth and become interconnected All major organs continue rapid growth and become interconnected Slide 8 The Second Trimester Fetus assumes distinct human appearance The nails harden and skin thickens, as well as the eye lashes, eye brows, and scalp hair appear during fifth and sixth months The nails harden and skin thickens, as well as the eye lashes, eye brows, and scalp hair appear during fifth and sixth months Fetus s visual and auditory senses are functional Fetus s visual and auditory senses are functional Slide 9 The Third Trimester All organ systems mature rapidly Fetus prepares for birth Fetus prepares for birth Fetus reaches age of viability, the point at which the fetus can survive outside of the uterus Fetus reaches age of viability, the point at which the fetus can survive outside of the uterus Fetus shows better-organized gross motor activity, and sleepiness/ waking activity Fetus shows better-organized gross motor activity, and sleepiness/ waking activity Towards end of ninth month, fetus is positioned head-down with limbs curled up in fetal position Towards end of ninth month, fetus is positioned head-down with limbs curled up in fetal position Slide 10 Slide 11 Teratogens External agents such as viruses, drugs, chemicals and radiation that can harm a developing embryo or fetus. External agents such as viruses, drugs, chemicals and radiation that can harm a developing embryo or fetus. Time when organ system or body part is at highest risk of effects from teratogens is known as sensitive period. Time when organ system or body part is at highest risk of effects from teratogens is known as sensitive period. Effects of teratogens on a body part or organ system are worst during the period when that structure is forming and growing most rapidly. Effects of teratogens on a body part or organ system are worst during the period when that structure is forming and growing most rapidly. Slide 12 Teratogens The same defect can be caused by different teratogens. The same defect can be caused by different teratogens. A variety of defects can be caused by a single teratogen. A variety of defects can be caused by a single teratogen. The longer the exposure or the higher the dose of the teratogen, the more likely it is that serious harm will be done. The longer the exposure or the higher the dose of the teratogen, the more likely it is that serious harm will be done. The long-term effects of a teratogen often depend on the quality of the postnatal environment. The long-term effects of a teratogen often depend on the quality of the postnatal environment. Slide 13 Slide 14 Subjective Assessment When pregnant female comes to you, the kinesiologist, you should ask: When pregnant female comes to you, the kinesiologist, you should ask: Name Name Age Age Medical history Medical history Genetic history Genetic history Previous surgeries Previous surgeries Current/past medications Current/past medications If they have ever or are using street drugs or smoking If they have ever or are using street drugs or smoking Alcohol/caffeine use Alcohol/caffeine use Occupation and current working status Occupation and current working status Marital status and children Marital status and children Slide 15 Objective Assessment When observing the client, evaluate: When observing the client, evaluate: Height Height Weight Weight BMI BMI Blood Pressure Blood Pressure General alignment General alignment Range painful movement Range painful movement Slide 16 Conditions During Pregnancy Constipation Constipation Affects half of pregnant women Affects half of pregnant women Causes: Causes: increase in progesterone increase in progesterone the colon absorbing more water the colon absorbing more water worse in first 13-14 weeks worse in first 13-14 weeks Treatment: Treatment: Drink plenty of fluids Drink plenty of fluids Eat high fiber foods Eat high fiber foods Take fiber supplements psylium husks, Metamucil, Ex-Lax Take fiber supplements psylium husks, Metamucil, Ex-Lax EXERCISE! EXERCISE! Slide 17 Conditions During Pregnancy Fatigue Fatigue Almost all women report increased fatigue in the 1st trimester. Almost all women report increased fatigue in the 1st trimester. Causes: Causes: Body is working harder Body is working harder More levels of progesterone, More levels of progesterone, Treatment: Treatment: Take naps Take naps Drink plenty of fluids, but avoid fluids 2-3hr before bed. Lac Drink plenty of fluids, but avoid fluids 2-3hr before bed. Lac Exercise Exercise Gentle stretches before bedtime can help prevent nighttime cramping Gentle stretches before bedtime can help prevent nighttime cramping Eat foods rich in protein Eat foods rich in protein Slide 18 Conditions During Pregnancy Back Ache Back Ache Many women experience back aches during 2nd and 3rd trimesters Many women experience back aches during 2nd and 3rd trimesters Causes: Causes: Poor posture Poor posture Extra weight Extra weight Change in centre of gravity Change in centre of gravity Hormones Hormones Treatment: Treatment: Pay attention to posture Pay attention to posture Exercise Exercise Swimming Swimming Pillow support in bed Pillow support in bed Ask for assistance when lifting heavy objects Ask for assistance when lifting heavy objects Heat/cold Heat/cold Massage Massage Support belt Support belt Wear supportive low heel shoes Wear supportive low heel shoes Slide 19 Benefits of Exercise During Pregnancy Maintenance/improvement of maternal fitness Maintenance/improvement of maternal fitness Control of excess weight gain Control of excess weight gain Improved posture and appearance Improved posture and appearance Increased energy Increased energy Improved sleep Improved sleep Decreased incidence of back pain Decreased incidence of back pain Improved self-esteem Improved self-esteem Decreased incidence of varicose veins Decreased incidence of varicose veins Decreased water retention Decreased water retention Decreased level of tension Decreased level of tension Possible decrease in complications during labour Possible decrease in complications during labour Shortened labour Shortened labour More rapid postpartum recovery More rapid postpartum recovery Slide 20 Disadvantages of Not Exercising Studies have shown that women who exercise do not experience an increase in: Studies have shown that women who exercise do not experience an increase in: Premature Rupture of Membranes (PROM) Premature Rupture of Membranes (PROM) When the membranes that hold the amniotic fluid break too early. When the membranes that hold the amniotic fluid break too early. Congenital Abnormalities Congenital Abnormalities Slide 21 Risk Reduction Pre-Eclampsia (Toxemia) Pre-Eclampsia (Toxemia) Occurs only during pregnancy and the postpartum period Occurs only during pregnancy and the postpartum period Affects 5-8% of all pregnancies Affects 5-8% of all pregnancies Causes blood vessels to constrict resulting in high blood pressure and a decrease in blood flow to organs and uterus. Causes blood vessels to constrict resulting in high blood pressure and a decrease in blood flow to organs and uterus. Having high blood pressure before pregnancy puts you at risk, also having a BMI of 30 or more Having high blood pressure before pregnancy puts you at risk, also having a BMI of 30 or more Characterized by high blood pressure and presence of protein in the urine Characterized by high blood pressure and presence of protein in the urine Symptoms: excess swelling of hands and feet, headaches, changes in visions, vomiting blood, ringing in the ears Symptoms: excess swelling of hands and feet, headaches, changes in visions, vomiting blood, ringing in the ears Occurs in the 2nd or 3rd trimesters Occurs in the 2nd or 3rd trimesters Slide 22 Kinesiologists Role Slide 23 Exercises During Pregnancy Low impact aerobics Low impact aerobics Water aerobics Water aerobics Walking Walking Kegels Kegels Pilates Pilates Yoga Yoga Cycling Cycling Swimming Swimming Slide 24 Kegels Help prepare body for labour Help prepare body for labour Kegel exercises are easy to do - can be done anywhere Kegel exercises are easy to do - can be done anywhere Kegels help strengthen the pelvic floor muscles Kegels help strengthen the pelvic floor muscles Many women do kegel exercises to prevent incontinence Many women do kegel exercises to prevent incontinence Slide 25 Yoga (prenatal) Help with breathing and relaxation Help with breathing and relaxation Promote feelings of well-being Promote feelings of well-being Energizing Energizing Stress relief Stress relief Improve posture Improve posture Meet others who are facing the same challenges Meet others who are facing the same challenges Note: Avoid positions lying on the back Note: Avoid positions lying on the back