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Fetal heart rate and uterine contractility during maternal exercise at term
W E Spinnewijn1, F K Lotgering, P C Struijk
1Department of Obstetrics and Gynecology, Erasmus University School of Medicine and Health Sciences, Rotterdam, The Netherlands.
Objective:
Our aim was to assess the physiologic response of human fetal heart rate and uterine contractility to moderately strenuous maternal exercise.
Study Design:
We measured fetal heart rate and intrauterine pressure with the use of internal monitoring before, during, and after maternal exercise at a heart rate of 140 beats/min on a cycle ergometer in 30 term women admitted for elective induction of labor. The fetal heart rate tracings were assessed by three observers and were classified according to Fischer et al. and Nijhuis et al., and the frequency and intensity of uterine contractions were determined.
Results:
Fetal outcome was good in all cases. There were no significant differences in Fischer scores between rest, exercise, and recovery periods. The fetuses displayed a heart rate pattern A and B, indicative of behavioral states 1F or 2F, 85% of the time, with state changes apparently independent of exercise. Uterine activity increased significantly during the exercise period, with a 5.5-fold increase in contraction frequency and a fourfold increase in time-pressure integral compared with rest, with rapid recovery after the exercise.
Conclusion:
Exercise in healthy pregnant women at term does not cause a change in fetal heart rate pattern suggestive of fetal distress or a change in fetal behavioral pattern, but it does significantly increase uterine activity.