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MATERNAL EXERCISE AS A SCREENING TEST FOR UTEROPLACENTAL INSUFFICIENCY (UPI)

The majority of distressed fetuses and infants discovered during labor and delivery occur in seemingly normal pregnancies. Identification of these infants prior to labor was attempted by screening mothers for UPI with an exercise test at 35-37 weeks gestation. In addition, the relationship between maternal physical fitness (PF) and UPI was evaluated. Fetal heart rate was measured prior to and following maternal exercise. A change in the fetal heart rate of more than 16 beats per minute was considered to be a “positive” test. Five fetuses of 54 women tested had positive tests, 4 of whom subsequently developed fetal distress during labor and delivery. Seven additional infants developed fetal distress during labor and delivery; 6 of these, however, had compromised umbilical circulations. PF was unrelated to UPI in the subjects tested. It is suggested that women with “positive” exercise tests be monitored carefully during labor and delivery and perhaps advised to avoid strenuous activity in the interim.