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Abstract Background The impact of physical activity (PA) during pregnancy on obstetrical outcomes remains controversial. We followed pregnant women who reported more than 3 hours of sustained PA per week during the first trimester of pregnancy. Cases Total five eligible women were followed. We observed small placenta from the first trimester (median: 0.68; interquartile [IQ]: 0.62–0.97 multiples of median [MoM]) to delivery (median: 0.82; IQ: 0.71–0.94 MoM), high uterine artery pulsatility index in the first (median: 1.82; IQ: 1.68–1.99 MoM) and second trimesters (median: 1.33; IQ: 1.11–1.56 MoM) of pregnancy. Placenta pathology revealed deep vasculopathy in three (60%) cases. However, all participants delivered at term and none of them experienced preeclampsia. Conclusion This small case series suggest that high PA volume in first trimester could interfere with deep placentation.