Master Class

Make Exercise Recommendations a Priority


Unfortunately, exercise—which can counter obesity—is not increasing at a concomitant rate. As a result, an emphasis on healthy lifestyles, with exercise as a central theme, has become the focus of national and international efforts undertaken by such groups as the World Health Organization, many of our medical societies, and even certain governmental agencies.

Just as exercise outside of pregnancy has clear benefits, exercise during pregnancy is also very important. For example, we know that a woman with gestational diabetes can certainly improve glucose control with exercise. However, there are clearly guidelines that must be followed when engaging in exercise during pregnancy.

In this month's Master Class, my guest professor is Raul Artal, M.D., who is an internationally recognized expert in the area of exercise physiology and exercise in pregnancy. He will lead us through specific recommendations concerning exercise during pregnancy, with references to gestational diabetes, weight control, and postpartum exercise.

Dr. Artal is professor and chair of the department of ob.gyn. at St. Louis University. He received his medical degree in Israel and his residency and fellowship training in the United States. He served as a faculty member at University of Southern California in Los Angeles and as chairman of ob.gyn. at the State University of New York, Syracuse, before attaining his current position. Dr. Artal is the lead author of the American College of Obstetricians and Gynecologists' Committee Opinion #267, “Exercise During Pregnancy and the Postpartum Period.”

Contraindications To Exercise In Pregnancy

Absolute Contraindications

Hemodynamically significant heart disease

Restrictive lung disease

Incompetent cervix/cerclage

Multiple gestation at risk for premature labor

Persistent second- or third-trimester bleeding

Placenta previa that occurs after 26 weeks' gestation

Premature labor during the current pregnancy

Ruptured membranes

Preeclampsia/pregnancy-induced hypertension

Relative Contraindications

Severe anemia

Unevaluated maternal cardiac arrhythmia

Chronic bronchitis

Poorly controlled type 1 diabetes

Extreme morbid obesity

Extreme underweight

History of extremely sedentary lifestyle

Intrauterine growth restriction in current pregnancy

Poorly controlled hypertension

Orthopedic limitations

Poorly controlled seizure disorder

Poorly controlled hyperthyroidism

Heavy smoker

Source: Obstet. Gynecol. 2002;99:171–3


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