Role of antenatal physiotherapy in high-risk pregnancy: A comprehensive review

Abstract

High-risk pregnancy represents a significant challenge in maternal healthcare due to its association with increased maternal and fetal morbidity and mortality. Conditions such as gestational diabetes mellitus, hypertensive disorders of pregnancy, obesity, multiple gestation, advanced maternal age, and previous obstetric complications necessitate specialized antenatal management. In recent years, antenatal physiotherapy has emerged as a crucial nonpharmacological intervention that contributes to improved maternal health, optimized fetal outcomes, and enhanced quality of life during pregnancy. Physiotherapy interventions including aerobic exercise, resistance training, pelvic floor muscle training, breathing exercises, postural correction, relaxation techniques, and hydrotherapy have demonstrated substantial benefits in managing pregnancy-related complications. Contemporary evidence indicates that appropriately prescribed physical activity may reduce the risk of gestational diabetes, excessive gestational weight gain, cesarean delivery, musculoskeletal pain, and psychological distress while promoting cardiovascular fitness and functional independence. This comprehensive review examines the role of antenatal physiotherapy in high-risk pregnancies, discusses physiological adaptations during pregnancy, outlines assessment and intervention strategies, evaluates maternal and fetal outcomes, and highlights emerging technological advances in antenatal rehabilitation. The review emphasizes evidence-based physiotherapy approaches and their integration into multidisciplinary obstetric care to improve pregnancy outcomes and maternal well-being.