Diving and Pregnancy

What Do We Really Know?

Abstract

 

Exercise during pregnancy has been advocated by many professional organizations to promote fetal heath and maternal well-being. Those same professional organizations do not recommend diving during pregnancy because of the potential adverse outcomes that have been observed in the animal model. In nonpregnant women, diving becomes problematic at depth as the ambient pressure increases and more gases become dissolved in the bloodstream. This can result in oxygen toxicity and nitrogen narcosis. Too rapid an ascent from depth can cause nitrogen emboli that can lodge in joints and tissue, resulting in decompression sickness, known as “the bends.” The best animal model to study the effects of diving on pregnancy is the sheep model. Bubbling has been observed in both ewes and their fetuses, with bubbles more common in the ewes. Repeated decompressions done improperly can lead to fetal death. Information on pregnancy outcomes in humans is more limited, with inconsistent data on diving and birth defects, spontaneous abortions, and stillbirth. Even in the face of overall increased resistance in the maternal or fetal placental circulations, the total placental blood flow is usually maintained, preventing adverse outcomes. It appears that the safest choice during pregnancy is to avoid diving; however, if the woman dove when she did not know she was pregnant, there is usually a normal outcome. If a women insists on diving during pregnancy, she should go to a depth of only 60 ft, and duration of her dive should be half that recommended by Navy dive table times.

Target Audience 

Obstetricians and gynecologists, family physicians

Learning Objectives 

After completing this CME activity, physicians should be better able to describe the normal physiologic changes encountered in the descent and ascent from a dive, to counsel patients who are interested in diving.