title: Restricted physical activity in pregnancy reduces maternal vascular resistance and improves fetal growth.
abstract: OBJECTIVE
  To test the efficacy of maternal activity restriction for reducing peripheral vascular resistance in normotensive pregnant women with raised total vascular resistance (TVR) and to evaluate its effect on fetal growth.
  
  
  METHODS
  This was a prospective case-control study of 30 women enrolled between 27 and 29 weeks' gestation. All patients met the following criteria: normal blood pressure before and during pregnancy, TVR between 1300 and 1400 dynes × s/cm5at enrolment, normal fetal Doppler parameters at enrolment and abdominal circumference between the 10thand 25thcentiles. Patients were assigned to activity restriction (activity-restriction group; n = 15) or no treatment (control group; n = 15) and were assessed after 4 weeks for TVR and fetal growth.
  
  
  RESULTS
  TVR at enrolment and estimated fetal weight centile were similar in the activity-restriction group vs controls (1358 ± 26 vs 1353 ± 30 dynes × s/cm5; 18th± 4 vs 19th± 4 centile; P = NS). After 4 weeks, the activity-restriction group compared with controls showed significantly lower TVR (1165 ± 159 vs 1314 ± 190 dynes × s/cm5; P < 0.05), which was associated with higher estimated fetal weight centile (25th± 5 vs 20th± 5 centile; P < 0.05). TVR was lower and estimated fetal weight centile higher for the activity-restriction group after 4 weeks compared with at enrolment.
  
  
  CONCLUSIONS
  In normotensive pregnant women with raised TVR, maternal activity restriction appears to be effective in reducing TVR and therefore enhancing fetal growth. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.
authors.affiliation: Department of Biomedicine, Obstetrics and Gynaecology, Policlinico Casilino, Tor Vergata University, Rome, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Vasapollo
authors.affiliation: Department of Biomedicine, Obstetrics and Gynaecology, Policlinico Casilino, Tor Vergata University, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Lo Presti
authors.affiliation: Department of Biomedicine, Obstetrics and Gynaecology, Policlinico Casilino, Tor Vergata University, Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gagliardi
authors.affiliation: Department of Biomedicine, Obstetrics and Gynaecology, Policlinico Casilino, Tor Vergata University, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Farsetti
authors.affiliation: Department of Biomedicine, Obstetrics and Gynaecology, Policlinico Casilino, Tor Vergata University, Rome, Italy.
authors.forename: G M
authors.identifier: http://orcid.org/0000-0002-0742-459X
authors.initials: GM
authors.lastname: Tiralongo
authors.affiliation: Department of Biomedicine, Obstetrics and Gynaecology, Policlinico Casilino, Tor Vergata University, Rome, Italy.
authors.forename: I
authors.identifier: http://orcid.org/0000-0001-9914-2153
authors.initials: I
authors.lastname: Pisani
authors.affiliation: Department of Cardiology, San Sebastiano Martire Hospital, Frascati, Rome, Italy.
authors.forename: G P
authors.identifier: http://orcid.org/0000-0002-6010-3234
authors.initials: GP
authors.lastname: Novelli
authors.affiliation: Department of Biomedicine, Obstetrics and Gynaecology, Policlinico Casilino, Tor Vergata University, Rome, Italy.
authors.forename: H
authors.initials: H
authors.lastname: Valensise
mesh_terms: D000328:Adult; D001724:Birth Weight / Q000502:physiology; D016022:Case-Control Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D047109:Fetal Development / Q000502:physiology*; D005317:Fetal Growth Retardation / Q000517:prevention & control; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011446:Prospective Studies; D016216:Ultrasonography, Prenatal; D014655:Vascular Resistance / Q000502:physiology*
keywords: activity restriction; bed rest; fetal growth; maternal echocardiography; maternal hemodynamics; total vascular resistance