Diving while pregnant??

Discussion in 'Diving Medicine' started by Ladydiver, Sep 26, 2000.

  1. Ladydiver

    Ladydiver Founder

    1,368
    8
    0
    We are all aware that the medical community discourages
    diving while pregnant. Do you as a research scientist have any information
    on this topic?

    Thanks Dr Deco,

     
  2. BillP

    BillP Senior Member

    685
    1
    0
    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
     
  3. Dr Deco

    Dr Deco Loggerhead Turtle

    # of Dives: I just don't log dives
    Location: Issaquah [20 miles east of Seattle], Washington.
    2,383
    86
    0
    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.
     
  4. Ladydiver

    Ladydiver Founder

    1,368
    8
    0
    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,
     
  5. Iguana Don

    Iguana Don Guest

    2,203
    2
    0
    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.
     
  6. Dr Deco

    Dr Deco Loggerhead Turtle

    # of Dives: I just don't log dives
    Location: Issaquah [20 miles east of Seattle], Washington.
    2,383
    86
    0
    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
     
  7. BillP

    BillP Senior Member

    685
    1
    0
    Hi don:

    "Gills" might not be that far away. See my post under "All About Rebreathers". (grin)

    Bill
     
  8. King_Neptune

    King_Neptune Founder

    908
    8
    0
    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!

    =-)

     
  9. photohikedive

    photohikedive Great White

    # of Dives:
    Location: In a State Park, on the coast of Florida
    3,934
    31
    0
    dolphins dive while preggo, why can't we?
     
  10. mislav

    mislav Scuba Instructor

    # of Dives:
    Location: Koh Phi Phi, Thailand
    959
    0
    0
    They freedive, we scuba dive. :D
     
  11. photohikedive

    photohikedive Great White

    # of Dives:
    Location: In a State Park, on the coast of Florida
    3,934
    31
    0
    bummer, they need to get certified

    do they use low volume masks?
     
  12. Sadamune

    Sadamune Nassau Grouper

    108
    0
    0
    Actually, according to what I've read, some cetaceans do suffer from DCS. A cetacean biologist can give you all the details no doubt, but I think deep diving species, e.g. Sperm Whales, can incur DCS injuries if they surface too quickly, even though they are freediving. Given the long durations of some these deep dives, a fast loading tissue can become saturated and pose a risk to the animal if it surfaces in a hurry. Point in case, I've read that barotrauma has been observed during necropsies of various cetaceans that have beached suspiciously after Naval warships blasted the water with sonar.

    As to the diving behaviour of pregnant cetaceans, I really don't know, but I wouldn't be surprised if some species exhibit modified dive behaviour during pregnancy. Also, as marine adapted mammals, I suspect there are some features of cetacean physiology that confer some resistance to DCS. Is there a cetacean biologist on the board that can fill in some details?

    Sadamune
     
  13. Dr Deco

    Dr Deco Loggerhead Turtle

    # of Dives: I just don't log dives
    Location: Issaquah [20 miles east of Seattle], Washington.
    2,383
    86
    0
    Hello readers :

    Bubbles and Cetaceans

    It is true that gas bubbles have been found in some organs of cetaceans following beachings. Whether these [apparently] rapid ascents result in true DCS of the type with which divers are familiar, is doubtful. By this is mean, divers think of joint pain (the bends) and neurological problems. I doubt this occurs in diving mammals.

    Bubbles and Humans

    There is no question that Doppler ultrasound devices show numerous bubbles in humans (coming from muscle and fat tissue) that are apparently harmless. The presence of these is not considered DCS, although some might consider it a sign of “sub clinical DCS.” It is probably bubbles in tissues of the mammals are of this nature.

    Dr Deco :doctor:

    The next class in Decompression Physiology for 2006 is September 16 – 17. :1book: http://wrigley.usc.edu/hyperbaric/advdeco.htm[/url
     
  14. DocVikingo

    DocVikingo Senior Member Staff Member

    5,568
    373
    83
    "J Obstet Gynaecol. 2006 Aug;26(6):509-13

    Scuba diving and pregnancy: Can we determine safe limits?

    Dowse MS, Gunby A, Moncad R, Fife C, Bryson P.

    Diving Diseases Research Centre (DDRC), Hyperbaric Medical Centre, Plymouth, UK.

    No human data, investigating the effects on the fetus of diving, have been published since 1989. We investigated any potential link between diving while pregnant and fetal abnormalities by evaluating field data from retrospective study No.1 (1990/2) and prospective study No.2 (1996/2000). Some 129 women reported 157 pregnancies over 1,465 dives. Latest gestational age reported while diving was 35 weeks. One respondent reported 92 dives during a single pregnancy, with two dives to 65 m in the 1st trimester. In study No.2 >90% of women ceased diving in the 1st trimester, compared with 65% in the earlier study. Overall, the women did not conduct enough dives per pregnancy, therefore no significant correlation between diving and fetal abnormalities could be established. These data indicate women are increasingly observing the diving industry recommendation and refraining from diving while pregnant. Field studies are not likely to be useful, or the way forward, for future diving and pregnancy research. Differences in placental circulation between humans and other animals limit the applicability of animal research for pregnancy and diving studies. It is unlikely that the effect of scuba diving on the unborn human fetus will be established."
     
  15. Reef Man

    Reef Man Divemaster

    # of Dives: 100 - 199
    Location: Gilbert Arizona
    415
    0
    0
    Wow....great stuff....It is stimulating to find this kind of information here...I have a daughter and daughter in law that we are trying to get into diving....if they do this is great information as both are in the child bearing years....Thanks for the great info!!!
     
  16. NataliaIvanova

    NataliaIvanova Garibaldi

    # of Dives: 0 - 24
    Location: UK
    1
    0
    0
    Hello Dr Deco!
    Was pleased to find so much usefull information on the subject of diving during pregnancy. Just wanted to learn if there are any new results of your researches since 2000 (last discussions on this forum)

    I recently done several dives to 18m, and 2 weeks later discovered i'm pregnant. I did not have any bad symptoms.
    And perhaps you could suggest if i need to do anything to decrease negative impact, please?

    Thank you
     
  17. drbill

    drbill The Lorax for the Kelp Forest

    # of Dives:
    Location: Santa Catalina Island, CA
    20,727
    3,298
    113
    If I ever find my ultimate dive buddy, I had better exercise caution and not get her pregnant. Not only am I too old for more kids, I'd lose my dive buddy for almost a year and have to return to solo diving!

    Seriously (moi?), I do find these topics of interest as well even though they will almost certainly not be relevant to my diving and life. It is good to have such information to point to if other divers ask (and I do dive with some absolutely wonderful women of child-bearing age).
     
  18. Jennie007

    Jennie007 Angel Fish

    # of Dives: 500 - 999
    Location: Belize
    11
    0
    0
    I have been diving for 5 years, never gotten DCS. Why would I get it now? Pregnant and therefore practicing extra conservative diving?

    Same with lung embolies.....
     
  19. Walter

    Walter Scuba Instructor

    18,583
    310
    0
    Jennie, is diving worth possible harm to your child? You do not have to get bend for your child to have DCS. Bubbles are often filtered out by the lungs preventing us from suffering from DCS. An unborn baby's lungs are not filtering out bubbles.
     
  20. bladephotog

    bladephotog Manta Ray

    849
    10
    18
    Walter, from one of her other posts - "To be honest my life here is worth more to me than the pregnancy. I can get pregnant again/ however I cant travel into my dream country again and build up a life here as a dive instructor with a child."

    I think this answers your question.
     

Share This Page