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How to manage
the pregnant
athlete?
Maita Poli de Araújo – MD, PhD
Professor of Medicine – Laureate International Universities
Head of the Section of Sport Gynecology– UNIFESP
Doctor at Fleury Laboratory
São Paulo - Brazil
Parmigiano TR, Zucchi EV, Araujo MP, Castro RA, Jarmy Di Bella ZYK, Girão MJBC, Sartori MGF. Pre-participation gynecological evaluation of female athletes. Einstein 2014;12:459-66
Health Team
Physiotherapist
Nutritionist
Osteopath
Psychologist
Sport physician
Obstetrician
Who is the pregnant athlete?
How to manage the pregnant athlete?
Sport Team
Team Manage
Head Coach
Fitness trainer
Biomechanical
Media
Sponsors
Train, train, win, TO GIVE BIRTH, train...
How to manage the pregnant athlete?
What does she want?
An example...
How to manage the pregnant athlete?
How to manage the pregnant athlete?
Serena Williams keeping up her intense
workouts up to eight months pregnant
How to manage the pregnant athlete?
How to manage the pregnant athlete?
Serena Williams makes Wimbledon final
10 months after childbirth
Pregnant on Summer Olympic Games
How to manage the pregnant athlete?
Name Year Country Sport Details
Juno Stover-Irwin 1952 USA Diving 3 months
DeAnne Hemmens 1996 USA Rowing 2 months
Cornelia Pohl 2000 GER Archery 7 weeks
Anky Van Grusven 2004 NED Equestrian 5 months
Katerina Kurova 2008 CZE Shooting 1 months
Nur Suryani Mohd Taibi 2012 MAL Shooting 8months
Kerri Walsh 2012 USA Beach volley 1 months
Anna-Maria Johason 2012 SWE Handball 3 months
Anky van Grunsven - 5 months Kerry Walsh - 1 month
How to manage the pregnant athlete?
2004 2012
Pregnant with gold medal !
Athletes with an uncomplicated pregnancy can
continue exercising, although some adjustments
in intensity and sport modality may be required !
How to manage the pregnant athlete?
Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.
Br J Sports Med. 2003;37(1):6-12
Sports to be
avoided
Risk of
falling
Physiologic risk
Direct trauma
to the
abdominal wall
How to manage the pregnant athlete?
JudoRugby
Ice hockeyBoxing
Direct trauma and risk of falling
Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.
Br J Sports Med. 2003;37(1):6-12
Wrestling
Taekwondo
How to manage the pregnant athlete?
Physiologic risk
Scuba diving
• The fetus is not
protected from
descompression
problems
• Risk of malformation
and gas embolism
after descompression
disease
Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.
Br J Sports Med. 2003;37(1):6-12
How to manage the pregnant athlete?
Risk of falling
(mainly during second and third trimester)
Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period.
Br J Sports Med. 2003;37(1):6-12
Exercício na gestação: benefícios e riscos
• Soccer
• Handball
• Basketball
• Volleyball
• Gymnastics artistic
• BMX, mountain cycling
• Freestyle skiing
How to manage the pregnant athlete?
Adjustments
in intensity
How to manage the pregnant athlete?
Moderate intensity aerobic exercise is
safe during pregnancy
Forczek W, Curyło M, Forczek B.Physical Activity Assessment During Gestation and Its Outcomes: A Review.
Obstet Gynecol Surv. 2017;72(7):425-444
How to manage the pregnant athlete?
How to manage the pregnant athlete?
Strength training
• Pay attention to technique and safety
• Caution with Supine position
• Avoid the Valsalva maneuver
• Avoid excessive pressure towards the pelvic floor
How to manage the pregnant athlete?
Supine position
Side-lying Sitting Standing
• Side effects are more likely to occur after 28
weeks of pregnancy
How to manage the pregnant athlete?
Limitations on Sport performance
Alysia Montano – USA - 800 metros
USATF's USA Outdoor Track and Field Championships (06/2014)
How to manage the pregnant athlete?
Estômago
– Cardiac
– Pulmonar
– Muskulosqueletic
Mottola et al,.VO2 peak prediction and exercise
prescription for pregnant women.
MedSci Sports Exerc 2006;38:1389-95.
How to manage the pregnant athlete?
Wolfe LA, Mottola MF. Aerobic exercise in pregnancy: an update. Can J Appl Physiol 1993;18:119-47
London 2012
Nur Suryani Mohamed Taibi – MAL - 8 months- Shooting
Limitations on Sport performance
How to manage the pregnant athlete?
Warning signs to stop exercising
1. Vaginal bleeding
2. Regular painful contractions
3. Amniotic fluid leakage
4. Dyspnoea prior to exertion
5. Syncope
6. Headache
7. Chest pain
8. Muscle weakness
9. Calf pain or swelling
How to manage the pregnant athlete?
Efeito
Take-home Message
How to manage the pregnant athlete?
Take-home Message
• Pregnant athletes should remain active during
pregnancy as long as she modifies her usual
exercise routine
• The goal of exercising in pregnancy is health
maintenance rather than sport performance
How to manage the pregnant athlete?
How to manage the pregnant athlete?

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Pregnant athlete

  • 1. How to manage the pregnant athlete? Maita Poli de Araújo – MD, PhD Professor of Medicine – Laureate International Universities Head of the Section of Sport Gynecology– UNIFESP Doctor at Fleury Laboratory São Paulo - Brazil
  • 2. Parmigiano TR, Zucchi EV, Araujo MP, Castro RA, Jarmy Di Bella ZYK, Girão MJBC, Sartori MGF. Pre-participation gynecological evaluation of female athletes. Einstein 2014;12:459-66 Health Team Physiotherapist Nutritionist Osteopath Psychologist Sport physician Obstetrician Who is the pregnant athlete? How to manage the pregnant athlete? Sport Team Team Manage Head Coach Fitness trainer Biomechanical Media Sponsors
  • 3. Train, train, win, TO GIVE BIRTH, train... How to manage the pregnant athlete? What does she want?
  • 4. An example... How to manage the pregnant athlete?
  • 5. How to manage the pregnant athlete? Serena Williams keeping up her intense workouts up to eight months pregnant
  • 6. How to manage the pregnant athlete?
  • 7. How to manage the pregnant athlete? Serena Williams makes Wimbledon final 10 months after childbirth
  • 8. Pregnant on Summer Olympic Games How to manage the pregnant athlete? Name Year Country Sport Details Juno Stover-Irwin 1952 USA Diving 3 months DeAnne Hemmens 1996 USA Rowing 2 months Cornelia Pohl 2000 GER Archery 7 weeks Anky Van Grusven 2004 NED Equestrian 5 months Katerina Kurova 2008 CZE Shooting 1 months Nur Suryani Mohd Taibi 2012 MAL Shooting 8months Kerri Walsh 2012 USA Beach volley 1 months Anna-Maria Johason 2012 SWE Handball 3 months
  • 9. Anky van Grunsven - 5 months Kerry Walsh - 1 month How to manage the pregnant athlete? 2004 2012 Pregnant with gold medal !
  • 10. Athletes with an uncomplicated pregnancy can continue exercising, although some adjustments in intensity and sport modality may be required ! How to manage the pregnant athlete?
  • 11. Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37(1):6-12 Sports to be avoided Risk of falling Physiologic risk Direct trauma to the abdominal wall How to manage the pregnant athlete?
  • 12. JudoRugby Ice hockeyBoxing Direct trauma and risk of falling Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37(1):6-12 Wrestling Taekwondo How to manage the pregnant athlete?
  • 13. Physiologic risk Scuba diving • The fetus is not protected from descompression problems • Risk of malformation and gas embolism after descompression disease Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37(1):6-12 How to manage the pregnant athlete?
  • 14. Risk of falling (mainly during second and third trimester) Artal R, O'Toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37(1):6-12 Exercício na gestação: benefícios e riscos • Soccer • Handball • Basketball • Volleyball • Gymnastics artistic • BMX, mountain cycling • Freestyle skiing How to manage the pregnant athlete?
  • 15. Adjustments in intensity How to manage the pregnant athlete?
  • 16. Moderate intensity aerobic exercise is safe during pregnancy Forczek W, Curyło M, Forczek B.Physical Activity Assessment During Gestation and Its Outcomes: A Review. Obstet Gynecol Surv. 2017;72(7):425-444 How to manage the pregnant athlete?
  • 17. How to manage the pregnant athlete?
  • 18. Strength training • Pay attention to technique and safety • Caution with Supine position • Avoid the Valsalva maneuver • Avoid excessive pressure towards the pelvic floor How to manage the pregnant athlete?
  • 19. Supine position Side-lying Sitting Standing • Side effects are more likely to occur after 28 weeks of pregnancy How to manage the pregnant athlete?
  • 20. Limitations on Sport performance Alysia Montano – USA - 800 metros USATF's USA Outdoor Track and Field Championships (06/2014) How to manage the pregnant athlete?
  • 21. Estômago – Cardiac – Pulmonar – Muskulosqueletic Mottola et al,.VO2 peak prediction and exercise prescription for pregnant women. MedSci Sports Exerc 2006;38:1389-95. How to manage the pregnant athlete?
  • 22. Wolfe LA, Mottola MF. Aerobic exercise in pregnancy: an update. Can J Appl Physiol 1993;18:119-47 London 2012 Nur Suryani Mohamed Taibi – MAL - 8 months- Shooting Limitations on Sport performance How to manage the pregnant athlete?
  • 23. Warning signs to stop exercising 1. Vaginal bleeding 2. Regular painful contractions 3. Amniotic fluid leakage 4. Dyspnoea prior to exertion 5. Syncope 6. Headache 7. Chest pain 8. Muscle weakness 9. Calf pain or swelling How to manage the pregnant athlete?
  • 24. Efeito Take-home Message How to manage the pregnant athlete?
  • 25. Take-home Message • Pregnant athletes should remain active during pregnancy as long as she modifies her usual exercise routine • The goal of exercising in pregnancy is health maintenance rather than sport performance How to manage the pregnant athlete?
  • 26. How to manage the pregnant athlete?