Variation in the amniotic fluid index following moderate physical activity in water during pregnancy

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Abstract
Background. To evaluate changes in the amniotic fluid index (AFI) in low‐risk pregnant women before and after physical activity in water. Methods. 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°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. Results. 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. Conclusions. 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.

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