Diving while pregnant??
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BillP
Senior Member
Hi Ladydiver:
I'm not Dr. Deco, but I do have some info that might help. Hope you don't mind me jumping in.
Maida Beth Taylor, MD wrote a chapter in Bove and Davis' DIVING MEDICINE that includes a discussion on Diving, Hyperbarics, and Pregnancy. She lists several reasons why women should not dive while pregnant. While a fetus seems to be at no increased risk for developing DCS than the mother, (and may even be at decreased risk) (1-4) the risk to the fetus if it does develop DCS may be significant. Animal studies in sheep show a high risk of fetal death if DCS is induced in the fetus (but studies in dogs and rats do not.) Since the fetal blood is oxygenated by the placenta, there are shunts around the fetus' lungs (patent foramen ovale and ductus arteriosus.) Because of these shunts, fetuses lack the filtering qualities of the lungs for bubbles. If bubbles do form in DCS the bubbles are more likely in a fetus to reach a vital organ. Most animal studies are done at depths that far exceed recreational diving limits (6.4-7.1 ata.)
I do not know of any studies on Arterial Gas Embolism (AGE) in diving, but the literature shows a very high rate of death in both mother and fetus in cases of AGE in non-diving incidents.
Because of the potential for increased risk to the fetus from diving you can't ethically ask pregnant women to dive for your study. But two studies in humans that surveyed pregnant women after they went diving have been done. One study showed no increased risk of birth defects or fetal loss. (5) The other suggested a higher incidence of low birth weight, birth defects, neonatal respiratory difficulties, and other problems in the group that continued diving perinatally, but a statistical analysis was not done. (6) The more severe (heart) abnormalities were associated with deeper diving (120-160 ft.)
The bottom line is that we don't know for sure what the effects of diving are on the human fetus. The risk is probably low in typical recreational diving not associated with DCS or AGE, but the potential injuries could be severe. I would say, NO do not dive while pregnant. It's not worth the potential risks. But if you do dive and then later find out you were pregnant, don't sweat it too much.
Bill
References
1.McIver RG, et. al.: Bends resistance in the fetus. In Preprints of scientific program. Annual Scientific Meeting. Washington, DC, Aerospace Medical Association, 1968
2. Neimiroff MJ, et. al.: Multiple hyperbaric exposure during pregnancy in sheep. Am J Obstet Gynecol 140:651, 1981
3. Powell MR, et. al.: Fetal and maternal bubbles detected noninvasively in sheep and goats following hyperbaric decompression. Undersea Biomed Res 12:59-69, 1985
4. Wilson JR, et. al.: Hyperbaric exposure during pregnancy in sheep: Staged and rapid decompression. Undersea Biomed Res 10:10-15, 1983
5. Bangasser SA: Medical profile of the woman scuba diver, In National Association of Underwater Instructors Proceeding of the 10th International Conference on Underwater Education, Colton, CA, NAUI, 1978, pp 31-40
6. Bolton ME: Scuba diving and fetal well-being: A survey of 208 women. Undersea Biomed Res 7: 183-189, 1980
I'm not Dr. Deco, but I do have some info that might help. Hope you don't mind me jumping in.
Maida Beth Taylor, MD wrote a chapter in Bove and Davis' DIVING MEDICINE that includes a discussion on Diving, Hyperbarics, and Pregnancy. She lists several reasons why women should not dive while pregnant. While a fetus seems to be at no increased risk for developing DCS than the mother, (and may even be at decreased risk) (1-4) the risk to the fetus if it does develop DCS may be significant. Animal studies in sheep show a high risk of fetal death if DCS is induced in the fetus (but studies in dogs and rats do not.) Since the fetal blood is oxygenated by the placenta, there are shunts around the fetus' lungs (patent foramen ovale and ductus arteriosus.) Because of these shunts, fetuses lack the filtering qualities of the lungs for bubbles. If bubbles do form in DCS the bubbles are more likely in a fetus to reach a vital organ. Most animal studies are done at depths that far exceed recreational diving limits (6.4-7.1 ata.)
I do not know of any studies on Arterial Gas Embolism (AGE) in diving, but the literature shows a very high rate of death in both mother and fetus in cases of AGE in non-diving incidents.
Because of the potential for increased risk to the fetus from diving you can't ethically ask pregnant women to dive for your study. But two studies in humans that surveyed pregnant women after they went diving have been done. One study showed no increased risk of birth defects or fetal loss. (5) The other suggested a higher incidence of low birth weight, birth defects, neonatal respiratory difficulties, and other problems in the group that continued diving perinatally, but a statistical analysis was not done. (6) The more severe (heart) abnormalities were associated with deeper diving (120-160 ft.)
The bottom line is that we don't know for sure what the effects of diving are on the human fetus. The risk is probably low in typical recreational diving not associated with DCS or AGE, but the potential injuries could be severe. I would say, NO do not dive while pregnant. It's not worth the potential risks. But if you do dive and then later find out you were pregnant, don't sweat it too much.
Bill
References
1.McIver RG, et. al.: Bends resistance in the fetus. In Preprints of scientific program. Annual Scientific Meeting. Washington, DC, Aerospace Medical Association, 1968
2. Neimiroff MJ, et. al.: Multiple hyperbaric exposure during pregnancy in sheep. Am J Obstet Gynecol 140:651, 1981
3. Powell MR, et. al.: Fetal and maternal bubbles detected noninvasively in sheep and goats following hyperbaric decompression. Undersea Biomed Res 12:59-69, 1985
4. Wilson JR, et. al.: Hyperbaric exposure during pregnancy in sheep: Staged and rapid decompression. Undersea Biomed Res 10:10-15, 1983
5. Bangasser SA: Medical profile of the woman scuba diver, In National Association of Underwater Instructors Proceeding of the 10th International Conference on Underwater Education, Colton, CA, NAUI, 1978, pp 31-40
6. Bolton ME: Scuba diving and fetal well-being: A survey of 208 women. Undersea Biomed Res 7: 183-189, 1980
Dr Deco
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Hello Ladydiver:
BillP has done a nice job on this and echoes my thoughts (or do I echo his). He gave a very nice description of the passage of bubbles in the absence of the pulmoanry filter in the fetal circulatory system. This is the crux of the problem when in utero - - no way to eliminate what, for us, are harmless bubbles in the venous sytem. I would add that the study listed as by MR Powell was mine (number 3 on the nice list of references), and we found that the fetal sheep and goats developed gas bubbles by the middle of the second trimester.
The measurements were made transcutaneously, and the second trimester was the earliest we could get blood flow signals. The mothers were dived on graded profiles (increasing bottom time) to their bends-no bends point. It was found that, even when this bottom time was one half of the bends-no bends point, the fetus was producing bubbles. Therefore the thought that you can dive to one half the allowed bottom time (NDL) is very suspect and unreliable.
The main concern with bubbles, as mentioned by BillP, is that, in the absence of the lung as a filter, the bubbles generated in tissues by the fetus can move about to embolize the brain and spinal cord. One of the goats was born with a limp, by the way.
Since the fetus in the EARLY first trimester does not move appreciably, I would not expect it to generate tissue micronuclei. I would speculate that it is UNLIKELY that a fetal DCS problem would develop before the woman knew that she was pregnant. By that time she recognizes it, however, I think that it would definitely be better to find a different exercise/activity for the next several months.
BillP has done a nice job on this and echoes my thoughts (or do I echo his). He gave a very nice description of the passage of bubbles in the absence of the pulmoanry filter in the fetal circulatory system. This is the crux of the problem when in utero - - no way to eliminate what, for us, are harmless bubbles in the venous sytem. I would add that the study listed as by MR Powell was mine (number 3 on the nice list of references), and we found that the fetal sheep and goats developed gas bubbles by the middle of the second trimester.
The measurements were made transcutaneously, and the second trimester was the earliest we could get blood flow signals. The mothers were dived on graded profiles (increasing bottom time) to their bends-no bends point. It was found that, even when this bottom time was one half of the bends-no bends point, the fetus was producing bubbles. Therefore the thought that you can dive to one half the allowed bottom time (NDL) is very suspect and unreliable.
The main concern with bubbles, as mentioned by BillP, is that, in the absence of the lung as a filter, the bubbles generated in tissues by the fetus can move about to embolize the brain and spinal cord. One of the goats was born with a limp, by the way.
Since the fetus in the EARLY first trimester does not move appreciably, I would not expect it to generate tissue micronuclei. I would speculate that it is UNLIKELY that a fetal DCS problem would develop before the woman knew that she was pregnant. By that time she recognizes it, however, I think that it would definitely be better to find a different exercise/activity for the next several months.
Hello BillP and Dr. Deco,
Thank you very much for the extensive information on this subject. In general this is a difficult subject to find information on and I really appreciate your input. I know this is an issue for many women divers.
Cheers,
Thank you very much for the extensive information on this subject. In general this is a difficult subject to find information on and I really appreciate your input. I know this is an issue for many women divers.
Cheers,
Iguana Don
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WOW!!!!
The amount of knowledge that is represented on this board is phenomenal, even the questions that don't pertain to me I find very interesting. ANY question a person may have can be answered here.
Isn't it funny that we came from the sea & here we are spending so much time and money to get back. Maybe in the next millenium our offspring will have gills, but then again rainreg & Dr Deco would be out of a job.
I want to thank all of the moderators & staff for doing such an excellent job. This will be my homesite forever.
Thanks again.
The amount of knowledge that is represented on this board is phenomenal, even the questions that don't pertain to me I find very interesting. ANY question a person may have can be answered here.
Isn't it funny that we came from the sea & here we are spending so much time and money to get back. Maybe in the next millenium our offspring will have gills, but then again rainreg & Dr Deco would be out of a job.
I want to thank all of the moderators & staff for doing such an excellent job. This will be my homesite forever.
Thanks again.
Dr Deco
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Hi Don:
I am pleased to hear that this Forum is of value and of interest. I will never forget the day in the fall of 1982, when I gave a talk at a Divers' Day event in Seattle entitled "Decompression Bubbles: Friend or Fiend?" I expected perhaps twenty people to come and hear a scientist speak. Actually the talk was in a large lecture room and even the aisles had people sitting in them. I was very adulated and surprised to discover that others found interesting what was to me a rather esoteric subject.
The main comment from the audience members was, "Could you expand each of your topics into about an one-hour talk?" With that was born the "Advanced Decompression Physiology" class that I have given (irregularly) in Seattle, Houston, and Cozumel over the past two decades. When and where others will be, I will post (one is tentatively being planned for spring at Catalina Island, Two Harbors). In addition, the Internet now allows dissemination of material worldwide.
I wish to add that much of this information presented here is derived from research paid for with tax dollars. I believe that we all like to know when we get something for our money, and this forum is one way of distributing that knowledge. It is my pleasure to be able to bring it to you hopefully in a digested and understandable fashion....
Michael Powell
I am pleased to hear that this Forum is of value and of interest. I will never forget the day in the fall of 1982, when I gave a talk at a Divers' Day event in Seattle entitled "Decompression Bubbles: Friend or Fiend?" I expected perhaps twenty people to come and hear a scientist speak. Actually the talk was in a large lecture room and even the aisles had people sitting in them. I was very adulated and surprised to discover that others found interesting what was to me a rather esoteric subject.
The main comment from the audience members was, "Could you expand each of your topics into about an one-hour talk?" With that was born the "Advanced Decompression Physiology" class that I have given (irregularly) in Seattle, Houston, and Cozumel over the past two decades. When and where others will be, I will post (one is tentatively being planned for spring at Catalina Island, Two Harbors). In addition, the Internet now allows dissemination of material worldwide.
I wish to add that much of this information presented here is derived from research paid for with tax dollars. I believe that we all like to know when we get something for our money, and this forum is one way of distributing that knowledge. It is my pleasure to be able to bring it to you hopefully in a digested and understandable fashion....
Michael Powell
BillP
Senior Member
Hi don:
"Gills" might not be that far away. See my post under "All About Rebreathers". (grin)
Bill
"Gills" might not be that far away. See my post under "All About Rebreathers". (grin)
Bill
King_Neptune
Founder
hehe
Ditto, I understand their enjoying the wealth of information. It's not often divers are presented with such an in-depth (no pun intended, hehe) look at something we are all effected by!
=-)
Ditto, I understand their enjoying the wealth of information. It's not often divers are presented with such an in-depth (no pun intended, hehe) look at something we are all effected by!
=-)
photohikedive
Guest
dolphins dive while preggo, why can't we?
They freedive, we scuba dive.photohikedive:
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