Cardiopulmonary exercise testing during pregnancy.

Area of Science:

• Reproductive Physiology
• Cardiopulmonary Function
• Exercise Science

Background:

• Cardiopulmonary exercise testing (CPET) is crucial for assessing cardiopulmonary health and exercise capacity.
• Pregnancy involves significant physiological adaptations impacting cardiovascular, respiratory, and metabolic systems.
• Existing CPET protocols do not account for pregnancy-specific physiological changes or safety considerations.

Purpose of the Study:

• To review practical considerations for conducting CPET during pregnancy.
• To highlight physiological adaptations during gestation and their impact on test interpretation.
• To address safety concerns unique to pregnant individuals and the fetus during exercise testing.

Main Methods:

• Comprehensive literature review of physiological adaptations during pregnancy.
• Analysis of standardized CPET methods and their modifications for pregnant populations.
• Examination of safety protocols, including screening, monitoring, and termination criteria.

Main Results:

• Pregnancy necessitates adjustments in resting heart rate, blood pressure, and respiratory function, altering physiological measurements.
• Unique concerns include fetal well-being, thermoregulation, ventilation, and musculoskeletal issues like low back pain.
• Standardized CPET procedures require modifications in screening, pre/post-test measurements, protocols, modality selection, and fetal monitoring.

Conclusions:

• CPET during pregnancy is valuable for identifying conditions and assessing exercise tolerance but requires tailored approaches.
• Current guidelines are insufficient, necessitating the development of pregnancy-specific CPET protocols and termination criteria.
• Implementing pregnancy-adjusted CPET ensures the safety of both the participant and the fetus.