Many women can safely exercise in moderation during pregnancy. However, some women should not exercise, or they should stop exercising if certain clinical findings are present.


Absolute contraindications:

(1) severe heart disease (valvular, ventricular dysfunction, arrhythmia)

(2) peripheral vascular disease

(3) uncontrolled hypertension

(4) uncontrolled thyroid disease

(5) severe liver disease

(6) severe renal disease

(7) any severe systemic disorder

(8) incompetent cervix

(9) 2 or more consecutive spontaneous abortions in previous pregnancies

(10) bleeding or placenta previa

(11) ruptured membranes during current pregnancy

(12) premature labor during current pregnancy

(13) development of pre-eclampsia or eclampsia during current pregnancy

(14) smoking

(15) excessive alcohol intake (> 2 drinks per day)

(16) very low body fat, severe malnutrition or history of severe eating disorder

(17) multiple pregnancy (triplets or more)

(18) suspected fetal distress, intrauterine growth retardation or macrosomia

(19) no prenatal care

(20) recent pulmonary embolism

(21) thrombophlebitis

(22) significant acute infection


Relative contraindications:

(1) mild heart disease (valvular, ventricular dysfunction, arrhythmia)

(2) pulmonary disease (asthma, COPD, etc.)

(3) anemia with hemoglobin < 10.5 g/dL

(4) diabetes mellitus

(5) medications affecting cardiac output or distribution of blood flow

(6) history of premature labor in previous pregnancies

(7) history of intrauterine growth retardation in previous pregnancies

(8) history of pre-eclampsia or eclampsia in previous pregnancies

(9) breech presentation in third trimester

(10) twin pregnancy after 24 weeks of gestation

(11) very low physical fitness

(12) poor nutrition

(13) excessive obesity


When to discontinue exercise and to seek medical attention:

(1) bloody vaginal discharge

(2) a "gush" of fluid from the vagina, suggestive of premature rupture of the membranes

(3) sudden swelling of face, hands or ankles

(4) swelling, redness, or pain in the calf of the leg, suggesting thrombophlebitis

(5) persistent or severe headaches

(6) persistent or severe visual disturbances

(7) unexplained spells of faintness or dizziness

(8) increase in blood pressure or heart rate which persists after exercise cessation

(9) excessive fatigue

(10) excessive chest pain

(11) excessive palpitations

(12) persistent contractions ( > 6 per hour), suggesting onset of premature labor

(13) unexplained abdominal pain

(14) insufficient weight gain (< 1 kg per month during the second and third trimesters)

(15) absence of fetal movements


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