What is the main reason why a woman who is older than 35 years may have difficulty achieving pregnancy?

Choice A reason: Cramping is a common symptom of pregnancy, especially in the third trimester, due to the stretching of the ligaments and muscles that support the uterus. It is not a specific sign of abruptio placentae, which is the premature separation of the placenta from the uterine wall.

Choice B reason: Uterine activity is a normal phenomenon of pregnancy, as the uterus contracts and relaxes periodically. It is not a specific sign of abruptio placentae, which is associated with increased uterine tone and tenderness.

Choice C reason: Bleeding is a possible sign of both abruptio placentae and placenta previa, which is the implantation of the placenta over or near the cervical os. However, bleeding is more common and severe in placenta previa than in abruptio placentae, as the latter can have concealed hemorrhage.

Choice D reason: Intense abdominal pain is the most prevalent clinical manifestation of abruptio placentae, as the blood accumulates behind the placenta and causes pressure and irritation of the uterine nerves. It is a distinguishing sign from placenta previa, which is usually painless.

Choice A reason: This is the best advice for the woman, as it acknowledges that jogging is safe and beneficial in early pregnancy, but also informs her that she may need to adjust her exercise intensity and duration as her pregnancy progresses. Walking is a low-impact aerobic activity that can be done throughout pregnancy, as long as there are no complications or contraindications. Walking can help maintain cardiovascular fitness, prevent excessive weight gain, and reduce the risk of gestational diabetes and preeclampsia.

Choice B reason: This is not a good advice for the woman, as it implies that jogging is harmful for her joints and that she should stop it immediately. Jogging is not necessarily bad for the joints, as long as the woman wears appropriate shoes, avoids uneven surfaces, and listens to her body. Jogging can also provide many health benefits for the woman and the fetus, such as improved mood, increased energy, and reduced stress².

Choice C reason: This is a false and alarming statement that may discourage the woman from exercising at all. Exercise during pregnancy is not dangerous for the fetus unless there are specific medical conditions or complications that prevent it. Exercise during pregnancy can improve the fetal growth, development, and oxygenation, as well as reduce the risk of preterm birth and low birth weight.

Choice D reason: This is an unrealistic and misleading statement that may cause the woman to overexert herself or ignore the signs of discomfort or fatigue. Exercise during pregnancy may need to be modified according to the woman's changing needs, abilities, and preferences. Some factors that may affect the type, frequency, intensity, and duration of exercise during pregnancy include the trimester, the fetal position, the maternal weight, the environmental temperature, and the presence of any symptoms or complications.