San Juan Dertkigil Marcia, Cecatti Jose Guilherme, Sarno Manuel A C, Cavalcante Sergio Ricardo, Marussi Emilio Francisco
Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil.
Acta Obstet Gynecol Scand. 2007;86(5):547-52. doi: 10.1080/00016340601181649.
To evaluate changes in the amniotic fluid index (AFI) in low-risk pregnant women before and after physical activity in water.
This was a prospective trial with a before-after approach. Women carried out moderate physical activity for 50 min, 3 times a week, while partially immersed in a swimming pool at 30 degrees C. Women with 2 or more previous cesarean sections, with a high-risk pregnancy or medical contra-indications for physical activity were excluded. They were evaluated weekly by ultrasonography, from 20 weeks of pregnancy until delivery, to evaluate AFI before and after physical activity in water. A second observer also performed the AFI measurements, in order to establish inter-observer variability. Analysis was performed using Student's t-test or Wilcoxon tests. The linear correlation coefficient was used to assess inter-observer variability.
A total of 25 pregnant women, 19-36 years of age, participated in the study between May 2003 and December 2004. A total of 232 ultrasonographic evaluations of AFI were carried out, a mean of 9.28 examinations per woman. Statistically significant increases in AFI were found following immersion at almost every week of pregnancy. The increase in AFI post-immersion compared to pre-immersion values ranged from 8.8 to 21.5%. There was good inter-observer agreement. The correlation coefficient for the inter-observer variability was 0.78 for pre-immersion measurements, and 0.70 for post-immersion measurements.
Physical activity in water appears to significantly increase AFI. Since this is a non-invasive therapy, we speculate that its clinical application may have significant value.
评估低风险孕妇在水中进行体育活动前后羊水指数（AFI）的变化。
这是一项采用前后对照方法的前瞻性试验。孕妇每周3次进行50分钟的适度体育活动，同时部分浸入30摄氏度的游泳池中。排除有2次或更多次既往剖宫产史、高危妊娠或存在体育活动医学禁忌证的妇女。从妊娠20周直至分娩，每周通过超声检查对她们进行评估，以评估水中体育活动前后的AFI。另一名观察者也进行AFI测量，以确定观察者间的变异性。使用学生t检验或威尔科克森检验进行分析。线性相关系数用于评估观察者间的变异性。
2003年5月至2004年12月期间，共有25名年龄在19至36岁之间的孕妇参与了该研究。共进行了232次AFI超声评估，每位妇女平均进行9.28次检查。在几乎妊娠的每一周，浸入水中后均发现AFI有统计学意义的增加。浸入后AFI相对于浸入前值的增加范围为8.8%至21.5%。观察者间一致性良好。观察者间变异性的相关系数在浸入前测量时为0.78，浸入后测量时为0.70。
水中体育活动似乎可显著增加AFI。由于这是一种非侵入性治疗方法，我们推测其临床应用可能具有重要价值。
