A.K. Ertan, S. Schanz, H.A. Tanriverdi, R. Meyberg, W. Schmidt
Doppler examinations of fetal and uteroplacental blood flow in AGA and IUGR fetuses before and after maternal physical exercise with the bicycle ergometer
Objective: To study changes in uteroplacental and fetal
circulation after maternal exercise in appropriate-for-gestational-
age fetuses (AGA) and intrauterine-growth-retarded
fetuses (IUGR).
Materials and method: 33 women with an uncomplicated
course of pregnancy and ten women with IUGR
were examined. Physical stress was caused through a
bicycle ergometer with 1.25 W/kg maternal weight.
Doppler examinations were performed in the umbilical
artery, fetal aorta, middle cerebral and in the uterine
artery. Fetal heart rate was documented by monitoring.
Maternal lactate and glucose levels as well as maternal
blood pressure and heart rate were recorded.
Results: No significant changes after cycling could be
observed in umbilical and uterine vessels either in the
normal pregnancies or in pregnancies with IUGR. In contrast,
in the fetal aorta an increase of the RI was recorded
in both groups (an increase of 16% [P<0.01] and 18%
[P<0.05], respectively for AGA and IUGR cases). In cerebral
arteries a decrease of the RI was observed after
cycling in both groups (a decrease of 24% [P<0.01] and
13% [P<0.05], respectively for AGA and IUGR cases).
In AGA fetuses the RI of the aorta and middle cerebral
artery returned to pre-test level by the 18th minute of
examination. In IUGR fetuses the RI of the aorta and middle
cerebral artery did not return to pre-test levels at the
end of the test. Fetal heart rate remained unchanged in
both groups.
Maternal blood pressure and heart rate increased during
the exertion phase but returned to initial values at the
end of the test. A 21% and 24% (for AGA and IUGR
groups respectively) reduction of maternal glucose values
after exercise was observed (P<0.001). Lactate values
doubled in both groups after exercise (P<0.001).
Conclusion: From the results obtained we conclude that
maternal exercise does not significantly alter uterine and
umbilical perfusion in AGA and IUGR pregnancies, suggesting
an absence of change in the uterine vascular bed
resistance. However, submaximal maternal exercise was
followed by fetal cerebral vasodilatation and an increase
of resistance in the fetal aorta that was more evident in
IUGR fetuses. This might be due to slight fetal hemoglobin
desaturation in those cases.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 32, 05/2004
Pages: 260 - 265
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