Bung P, Spätling L, Huch R, Huch A
Universitäts-Frauenklinik Bonn.
Geburtshilfe Frauenheilkd. 1988 Jul;48(7):500-11. doi: 10.1055/s-2008-1026527.
Against the background of dramatic changes that took place in the history of sports during the past one hundred years, we are today discussing with regard to the compatibility of sport and pregnancy whether the extent of sports activities before pregnancy contributes to the amount of stress tolerated during pregnancy. Animal experimental studies on the effect of physical stress on the foetus cannot always be transferred to man, and hence recommendations made to pregnant women are often purely empirical. The article reports on the results of an examination of a professional woman athlete during pregnancy: Various maternal circulatory and respiratory parameters were recorded in this primigravida of 25 years of age, who had been regularly active as a competitive runner for 12 years, during the 24th week of pregnancy and from the 28th week of pregnancy onwards, at intervals of 14 days and post partum, at rest and during steady-state load on a bicycle ergometer (6 minutes each at 40 and 70 watts load, respectively) and a step-by-step load increasing every minute by 15 watts until attainment of a maternal heart rate of 150 beats per minute. The results were compared with those in a group of pregnant women who had not been competitive sportswomen. During continued training as per schedule up to the 36th week of pregnancy of the athlete, there was hardly any change in performance, and there was a marked difference against the other women. The pulse at rest was lower by a mean of 30 beats in the athlete during pregnancy, clearly indicating maintenance of the economic cardiac mechanism known to occur in trained persons, which produces a greater cardiac output via an increased stroke volume at a lower heart rate. This difference was impressively demonstrated under different loads. Another example of more economic management of an identical load is also seen, for instance, in the lower oxygen uptake and lower respiratory rate. Even at a maternal heart rate of 150 beats per minute the foetus of the athlete did not show any signs of stress under test conditions. In a measurement "at site" during the 38th week of pregnancy under routine and training conditions with relevant sprints and a maternal heart rate increase to more than 170 beats per minute, however, foetal behaviour displaying bradycardia clearly showed the existence of tolerance limits for foetal supply.(ABSTRACT TRUNCATED AT 400 WORDS)
在过去一百年体育史上发生巨大变革的背景下,我们如今正在探讨运动与怀孕的兼容性问题,即怀孕前的运动活动程度是否会对孕期所能承受的压力量产生影响。关于身体应激对胎儿影响的动物实验研究结果并不总能直接应用于人类,因此给孕妇的建议往往纯粹基于经验。本文报道了一名职业女运动员孕期的检查结果:对这位25岁的初产妇进行了多项记录,她作为一名有竞争力的跑步运动员有规律地训练了12年。在怀孕第24周、从怀孕第28周起每隔14天以及产后,分别在休息状态以及在自行车测力计上进行稳态负荷(分别在40瓦和70瓦负荷下各6分钟)和每分钟以15瓦的幅度逐步增加负荷直至孕妇心率达到150次/分钟的状态下,记录了各种母体循环和呼吸参数。将结果与一组非职业女运动员的孕妇进行了比较。在该运动员按计划持续训练至怀孕第36周期间,其运动表现几乎没有变化,与其他女性相比有显著差异。孕期该运动员休息时的脉搏平均比其他人低30次,清楚地表明训练有素者所具有的经济心脏机制得以维持,即通过较低心率下增加的每搏输出量产生更大的心输出量。这种差异在不同负荷下都得到了显著体现。在相同负荷下更经济管理的另一个例子是较低的摄氧量和呼吸频率。即使在孕妇心率达到150次/分钟时,该运动员的胎儿在测试条件下也未表现出任何应激迹象。然而,在怀孕第38周的一次常规和训练条件下的“现场”测量中,进行相关短跑且孕妇心率升至超过170次/分钟时,胎儿出现心动过缓的行为清楚地表明胎儿供血存在耐受极限。(摘要截选至400字)