<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg1.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">286 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y5 ff2 fs2 fc0 sc0 ls0 ws3"> <span class="ff3 fs3 ls7 v1">NPT NA GR<span class="blank _1"> </span>AVIDEZ (DAN) </span></div><div class="t m0 x4 h5 y6 ff3 fs3 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y7 ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _1"> </span>nutrição<span class="blank _1"> </span> <span class="blank _1"> </span>parenteral <span class="blank _1"> </span>pode <span class="blank _1"> </span>ser <span class="blank _2"> </span>dada <span class="blank _1"> </span>inicialmente <span class="blank _1"> </span>p<span class="blank _1"> </span>or </div><div class="t m0 x1 h4 y8 ff2 fs2 fc0 sc0 ls7 ws3">via <span class="blank"> </span>periférica, <span class="blank _3"> </span>uma <span class="blank"> </span>vez <span class="blank _3"> </span>que <span class="blank"> </span>o <span class="blank"> </span>quadro <span class="blank _3"> </span>de <span class="blank"> </span>h<span class="blank _0"></span>iperêmese </div><div class="t m0 x1 h4 y9 ff2 fs2 fc0 sc0 ls7 ws3">frequentemente se resolve após 2 a 3 semanas. </div><div class="t m0 x3 h4 ya ff2 fs2 fc0 sc0 ls7 ws3">Quando <span class="blank"> </span>há <span class="blank"> </span>necessidade <span class="blank"> </span>de <span class="blank"> </span>NP <span class="blank"> </span>por <span class="blank"> </span>período <span class="blank _3"> </span>mais </div><div class="t m0 x1 h4 yb ff2 fs2 fc0 sc0 ls7 ws3">prolongado, <span class="blank _4"> </span>a <span class="blank _4"> </span>avaliação <span class="blank _4"> </span>pre<span class="blank _0"></span>cisa <span class="blank _4"> </span>da <span class="blank _4"> </span>necessidade <span class="blank _4"> </span>de </div><div class="t m0 x1 h4 yc ff2 fs2 fc0 sc0 ls7 ws3">nutrientes <span class="blank _3"> </span>é <span class="blank _3"> </span>dificultada <span class="blank _3"> </span>pela <span class="blank _3"> </span>falta <span class="blank _3"> </span>de <span class="blank _3"> </span>d<span class="blank _0"></span>ados <span class="blank _3"> </span>científicos </div><div class="t m0 x1 h4 yd ff2 fs2 fc0 sc0 ls7 ws3">relacionados <span class="blank _5"> </span>às <span class="blank _5"> </span>necessidades <span class="blank _5"> </span>nutricionais <span class="blank _5"> </span>da <span class="blank _5"> </span>NP <span class="blank _6"> </span>na </div><div class="t m0 x1 h4 ye ff2 fs2 fc0 sc0 ls7 ws3">gravidez. </div><div class="t m0 x3 h4 yf ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _2"> </span>necessidade <span class="blank _1"> </span>ca<span class="blank _1"> </span>lórica <span class="blank _1"> </span>diária <span class="blank _2"> </span>é <span class="blank _2"> </span>GEB <span class="blank _2"> </span>x <span class="blank _1"> </span>1,76 <span class="blank _7"> </span><span class="ff4 ls1">\u2013</span> <span class="blank _2"> </span>2,0. <span class="blank _2"> </span>A </div><div class="t m0 x1 h4 y10 ff2 fs2 fc0 sc0 ls7 ws3">relação <span class="blank _1"> </span>g<span class="blank _1"> </span>rama <span class="blank _1"> </span>de <span class="blank _2"> </span>nitrogênio <span class="blank _2"> </span>/kcal <span class="blank _2"> </span>não <span class="blank _2"> </span>nitrogenada <span class="blank _1"> </span>deve </div><div class="t m0 x1 h4 y11 ff2 fs2 fc0 sc0 ls7 ws3">ser <span class="blank _8"> </span>de <span class="blank _8"> </span>1:156. <span class="blank _8"> </span>E <span class="blank _8"> </span>a <span class="blank _8"> </span>gordura <span class="blank _9"> </span>deve <span class="blank _9"> </span>representar <span class="blank _8"> </span>20% <span class="blank _8"> </span>das </div><div class="t m0 x1 h4 y12 ff2 fs2 fc0 sc0 ls7 ws3">calorias. </div><div class="t m0 x3 h4 y13 ff2 fs2 fc0 sc0 ls7 ws3">A re<span class="blank _1"> </span>comendação é <span class="blank _1"> </span>que <span class="blank _1"> </span>as e<span class="blank _1"> </span>mulsões <span class="blank _1"> </span>lipídicas devam </div><div class="t m0 x1 h4 y14 ff2 fs2 fc0 sc0 ls7 ws3">ser <span class="blank _1"> </span>ofertadas <span class="blank _1"> </span>durante <span class="blank _1"> </span>20 <span class="blank _1"> </span>a <span class="blank _1"> </span>24 <span class="blank _1"> </span>horas, <span class="blank _1"> </span>como <span class="blank _1"> </span>parte <span class="blank _1"> </span>da <span class="blank _1"> </span>NP, </div><div class="t m0 x1 h4 y15 ff2 fs2 fc0 sc0 ls7 ws3">fornecendo <span class="blank _5"> </span>30 <span class="blank _5"> </span>a <span class="blank _a"> </span>45% <span class="blank _5"> </span>das <span class="blank _5"> </span>calorias <span class="blank _5"> </span>totais, <span class="blank _5"> </span>al<span class="blank _1"> </span>ém <span class="blank _5"> </span>dos </div><div class="t m0 x1 h4 y16 ff2 fs2 fc0 sc0 ls7 ws3">ácidos <span class="blank _b"> </span>graxos <span class="blank _b"> </span>essenciais <span class="blank _b"> </span>ne<span class="blank _0"></span>cessários <span class="blank _b"> </span>ao </div><div class="t m0 x1 h4 y17 ff2 fs2 fc0 sc0 ls7 ws3">desenvolvimento <span class="blank _2"> </span>do <span class="blank _7"> </span>feto. <span class="blank _1"> </span>Essa <span class="blank _2"> </span>conduta <span class="blank _7"> </span>a<span class="blank _0"></span>juda <span class="blank _2"> </span>a <span class="blank _2"> </span>evita<span class="blank _1"> </span>r <span class="blank _1"> </span>a </div><div class="t m0 x1 h4 y18 ff2 fs2 fc0 sc0 ls7 ws3">hiperglicemia <span class="blank _c"> </span>materna, <span class="blank _c"> </span>o <span class="blank _c"> </span>que <span class="blank _c"> </span>aumenta <span class="blank _c"> </span>o <span class="blank _c"> </span>risco <span class="blank _c"> </span>d<span class="blank _0"></span>e </div><div class="t m0 x1 h4 y19 ff2 fs2 fc0 sc0 ls7 ws3">macrossomia <span class="blank _d"> </span>fetal, <span class="blank _d"> </span>retardo <span class="blank _4"> </span>na <span class="blank _d"> </span>matu<span class="blank _1"> </span>ração <span class="blank _4"> </span>pulmonar, </div><div class="t m0 x1 h4 y1a ff2 fs2 fc0 sc0 ls7 ws3">hipoglicemia neonatal e morte fetal. </div><div class="t m0 x3 h4 y1b ff2 fs2 fc0 sc0 ls7 ws3">O <span class="blank _7"> </span>ritmo <span class="blank _2"> </span>ó<span class="blank _1"> </span>timo <span class="blank _2"> </span>de<span class="blank _1"> </span> <span class="blank _2"> </span>administração <span class="blank _7"> </span>de <span class="blank _7"> </span>glicose <span class="blank _2"> </span>é <span class="blank _7"> </span>de <span class="blank _7"> </span>4 <span class="blank _2"> </span>a </div><div class="t m0 x1 h4 y1c ff2 fs2 fc0 sc0 ls7 ws3">5mg/kg/min, o que aumenta a insulina endógena. </div><div class="t m0 x3 h4 y1d ff2 fs2 fc0 sc0 ls7 ws3">Em <span class="blank"> </span>relação <span class="blank _3"> </span>aos <span class="blank"> </span>am<span class="blank _0"></span>inoácidos, <span class="blank"> </span>a <span class="blank _8"> </span>s<span class="blank _1"> </span>olução <span class="blank"> </span>deve <span class="blank _8"> </span>ser </div><div class="t m0 x1 h4 y1e ff2 fs2 fc0 sc0 ls7 ws3">semelhante <span class="blank _e"> </span>à <span class="blank _e"> </span>utilizada <span class="blank _e"> </span>pa<span class="blank _0"></span>ra <span class="blank _e"> </span>prematuros, <span class="blank _e"> </span>com <span class="blank _f"> </span>a </div><div class="t m0 x1 h4 y1f ff2 fs2 fc0 sc0 ls7 ws3">quantidade <span class="blank _9"> </span>de <span class="blank _7"> </span>fenilalanina <span class="blank _9"> </span>e <span class="blank _7"> </span>glicina <span class="blank _7"> </span>m<span class="blank _1"> </span>enor <span class="blank _10"> </span>e <span class="blank _10"> </span>a <span class="blank _10"> </span>relação </div><div class="t m0 x1 h4 y20 ff2 fs2 fc0 sc0 ls7 ws3">entre <span class="blank _6"> </span>amin<span class="blank _1"> </span>oácidos <span class="blank"> </span>esse<span class="blank _1"> </span>nciais <span class="blank"> </span>e <span class="blank _5"> </span>não <span class="blank _5"> </span>essenciais <span class="blank _6"> </span>mais </div><div class="t m0 x1 h4 y21 ff2 fs2 fc0 sc0 ls7 ws3">próxima <span class="blank _10"> </span>do<span class="blank _1"> </span> <span class="blank _10"> </span>ideal. <span class="blank _9"> </span>É <span class="blank _9"> </span>necessário <span class="blank _10"> </span>que <span class="blank _9"> </span>4,5<span class="blank _1"> </span>% <span class="blank _9"> </span>das <span class="blank _10"> </span>calo<span class="blank _1"> </span>rias<span class="blank _0"></span> </div><div class="t m0 x1 h4 y22 ff2 fs2 fc0 sc0 ls7 ws3">sejam fornecidas através de ácidos graxos essenciais. </div><div class="t m0 x3 h4 y23 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y24 ff2 fs2 fc0 sc0 ls7 ws3">Indicações da terapia nutricional na gravidez: </div><div class="t m0 x1 h4 y25 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Peso <span class="blank _8"> </span>antes <span class="blank _8"> </span>da <span class="blank _8"> </span>gestação <span class="blank _8"> </span>menor <span class="blank _8"> </span>que <span class="blank _8"> </span>10% <span class="blank _8"> </span>do <span class="blank _8"> </span>peso </span></div><div class="t m0 x1 h4 y26 ff2 fs2 fc0 sc0 ls7 ws3">corpóreo ideal. </div><div class="t m0 x1 h4 y27 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Excessiva <span class="blank"> </span>p<span class="blank _1"> </span>erda <span class="blank _6"> </span>de <span class="blank"> </span>peso, <span class="blank _5"> </span>em <span class="blank"> </span>g<span class="blank _1"> </span>eral <span class="blank"> </span>5,0 <span class="blank _6"> </span>a<span class="blank _1"> </span> <span class="blank"> </span>6,0kg, </span></div><div class="t m0 x1 h4 y28 ff2 fs2 fc0 sc0 ls7 ws3">durante o primeiro trimestre de gravidez. </div><div class="t m0 x1 h4 y29 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls3 ws3"> <span class="blank _4"> </span>Inadequad<span class="blank _0"></span>o <span class="blank"> </span>ganho <span class="blank"> </span>d<span class="blank _0"></span>e <span class="blank"> </span>peso <span class="blank"> </span>dur<span class="blank _0"></span>ante <span class="blank"> </span>o <span class="blank"> </span>s<span class="blank _0"></span>egundo <span class="blank"> </span>e </span></div><div class="t m0 x1 h4 y2a ff2 fs2 fc0 sc0 ls7 ws3">terceiro trimestres de gravidez. </div><div class="t m0 x1 h4 y2b ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Intercorrências clínicas e obstétricas. </span></div><div class="t m0 x3 h4 y2c ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y2d ff2 fs2 fc0 sc0 ls7 ws3">Solução para nutrição parenteral total recomendada<span class="ff1">: </span></div><div class="c x0 y2e w2 h6"><div class="t m0 x5 h7 y2f ff2 fs4 fc0 sc0 ls7 ws3"> </div></div><div class="c x6 y2e w3 h6"><div class="t m0 x5 h7 y2f ff2 fs4 fc0 sc0 ls7 ws3">Conteúdo<span class="blank _0"></span> </div><div class="t m0 x5 h7 y30 ff2 fs4 fc0 sc0 ls7 ws3">(g) </div></div><div class="c x7 y2e w4 h6"><div class="t m0 x5 h7 y2f ff2 fs4 fc0 sc0 ls7 ws3">Calorias </div></div><div class="c x8 y2e w5 h6"><div class="t m0 x5 h7 y2f ff2 fs4 fc0 sc0 ls7 ws3">% Calorias </div></div><div class="c x0 y31 w2 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls7 ws3">Glicose </div></div><div class="c x6 y31 w3 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls8 ws3">500 <span class="ls7"> </span></div></div><div class="c x7 y31 w4 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls7 ws3">1700 </div></div><div class="c x8 y31 w5 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls8 ws3">66 <span class="ls7"> </span></div></div><div class="c x0 y33 w2 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls7 ws3">Gordura </div></div><div class="c x6 y33 w3 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls8 ws3">50 <span class="ls7"> </span></div></div><div class="c x7 y33 w4 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls8 ws3">550 <span class="ls7"> </span></div></div><div class="c x8 y33 w5 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls8 ws3">21 <span class="ls7"> </span></div></div><div class="c x0 y34 w2 h9"><div class="t m0 x5 h7 y35 ff2 fs4 fc0 sc0 ls7 ws3">Nitrogênio </div><div class="t m0 x5 h7 y2f ff2 fs4 fc0 sc0 ls7 ws3">(85g de </div><div class="t m0 x5 h7 y30 ff2 fs4 fc0 sc0 ls7 ws3">proteína) </div></div><div class="c x6 y34 w3 h9"><div class="t m0 x5 h7 y35 ff2 fs4 fc0 sc0 ls7 ws3">13,4 </div></div><div class="c x7 y34 w4 h9"><div class="t m0 x5 h7 y35 ff2 fs4 fc0 sc0 ls8 ws3">335 <span class="ls7"> </span></div></div><div class="c x8 y34 w5 h9"><div class="t m0 x5 h7 y35 ff2 fs4 fc0 sc0 ls8 ws3">13 <span class="ls7"> </span></div></div><div class="c x0 y36 w2 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls7 ws3">Total </div></div><div class="c x6 y36 w3 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls7 ws3"> </div></div><div class="c x7 y36 w4 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls7 ws3">2.585 </div></div><div class="c x8 y36 w5 h8"><div class="t m0 x5 h7 y32 ff2 fs4 fc0 sc0 ls8 ws1">100<span class="ls7 ws3"> </span></div></div><div class="t m0 x3 h5 y37 ff3 fs3 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y38 ff2 fs2 fc0 sc0 ls7 ws3">A re<span class="blank _1"> </span>sposta <span class="blank _1"> </span>à te<span class="blank _1"> </span>rapia nutricional <span class="blank _1"> </span>na <span class="blank _1"> </span>gravidez d<span class="blank _1"> </span>eve ser </div><div class="t m0 x1 h4 y39 ff2 fs2 fc0 sc0 ls7 ws3">analisada <span class="blank _f"> </span>através <span class="blank _f"> </span>de <span class="blank _11"> </span>exame <span class="blank _11"> </span>clínico, <span class="blank _f"> </span>do <span class="blank _11"> </span>balanço </div><div class="t m0 x1 h4 y3a ff2 fs2 fc0 sc0 ls7 ws3">nitrogenado, <span class="blank _7"> </span>do <span class="blank _7"> </span>nível <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _7"> </span>albu<span class="blank _0"></span>mina <span class="blank _7"> </span>sérica <span class="blank _7"> </span>e <span class="blank _7"> </span>de <span class="blank _2"> </span>variação </div><div class="t m0 x1 h4 y3b ff2 fs2 fc0 sc0 ls7 ws3">no número de linfócitos. </div><div class="t m0 x3 h4 y3c ff2 fs2 fc0 sc0 ls7 ws3">O <span class="blank _7"> </span>pro<span class="blank _1"> </span>gnóstico <span class="blank _7"> </span>fetal <span class="blank _10"> </span>com <span class="blank _10"> </span>NP <span class="blank _7"> </span>demonstra <span class="blank _10"> </span>que <span class="blank _10"> </span>o <span class="blank _10"> </span>peso </div><div class="t m0 x1 h4 y3d ff2 fs2 fc0 sc0 ls7 ws3">dos <span class="blank _8"> </span>fetos <span class="blank _9"> </span>a<span class="blank _1"> </span>o <span class="blank _9"> </span>nascimento <span class="blank _8"> </span>atinge <span class="blank _8"> </span>e, <span class="blank _8"> </span>inclusive, <span class="blank _8"> </span>supera <span class="blank _9"> </span>a </div><div class="t m0 x1 h4 y3e ff2 fs2 fc0 sc0 ls7 ws3">média de peso paridade gestacional. </div><div class="t m0 x3 h4 y3f ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y40 ff2 fs2 fc0 sc0 ls7 ws3">Complicações da NPT na gravidez: </div><div class="t m0 x1 h4 y41 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Relacionadas <span class="blank _c"> </span>ao <span class="blank _c"> </span>cateter <span class="blank _12"> </span>- <span class="blank _c"> </span>É <span class="blank _c"> </span>relatado <span class="blank _c"> </span>risc<span class="blank _1"> </span>o <span class="blank _c"> </span>de </span></div><div class="t m0 x1 h4 y42 ff2 fs2 fc0 sc0 ls7 ws3">infecção <span class="blank _4"> </span>ou <span class="blank _4"> </span>trombose <span class="blank _4"> </span>associada <span class="blank _4"> </span>ao <span class="blank _4"> </span>uso <span class="blank _4"> </span>de <span class="blank _4"> </span>cateter </div><div class="t m0 x1 h4 y43 ff2 fs2 fc0 sc0 ls7 ws3">central <span class="blank _1"> </span>de <span class="blank _1"> </span>inserção <span class="blank _1"> </span>periférica, <span class="blank _1"> </span>o <span class="blank _1"> </span>que <span class="blank _2"> </span>dificulta <span class="blank _1"> </span>a <span class="blank _1"> </span>utilização </div><div class="t m0 x1 h4 y44 ff2 fs2 fc0 sc0 ls7 ws3">deste dispositivo na mulher grávida. </div><div class="t m0 x1 h4 y45 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Relacionadas <span class="blank _a"> </span>à <span class="blank _a"> </span>glicose <span class="blank _4"> </span>- <span class="blank _a"> </span>a <span class="blank _a"> </span>hipe<span class="blank _1"> </span>rglicemia <span class="blank _5"> </span>é<span class="blank _1"> </span> <span class="blank _5"> </span>u<span class="blank _1"> </span>ma </span></div><div class="t m0 x1 h4 y46 ff2 fs2 fc0 sc0 ls7 ws3">complicação <span class="blank _1"> </span>comum <span class="blank _2"> </span>na <span class="blank _1"> </span>NP <span class="blank _1"> </span>na <span class="blank _1"> </span>gra<span class="blank _1"> </span>videz. <span class="blank _1"> </span>Poderá <span class="blank _1"> </span>ocorrer </div><div class="t m0 x1 h4 y47 ff2 fs2 fc0 sc0 ls7 ws3">coma <span class="blank _2"> </span>hiperosmolar <span class="blank _2"> </span>e <span class="blank _2"> </span>ó<span class="blank _1"> </span>bito <span class="blank _2"> </span>do <span class="blank _2"> </span>concepto. <span class="blank _7"> </span>Tax<span class="blank _0"></span>as <span class="blank _2"> </span>al<span class="blank _1"> </span>tas <span class="blank _1"> </span>de </div><div class="t m0 x9 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">glicose <span class="blank _10"> </span>podem <span class="blank _10"> </span>acarretar <span class="blank _10"> </span>feto <span class="blank _7"> </span>mac<span class="blank _1"> </span>rossômico, <span class="blank _7"> </span>com <span class="blank _10"> </span>óbito </div><div class="t m0 x9 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">por volta da 37ª semana de gestação. </div><div class="t m0 x9 h4 y48 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Relacionadas <span class="blank _d"> </span>aos <span class="blank _d"> </span>am<span class="blank _1"> </span>inoácidos <span class="blank _c"> </span>-<span class="blank _0"></span> <span class="blank _d"> </span>poderá <span class="blank _d"> </span>o<span class="blank _1"> </span>correr </span></div><div class="t m0 x9 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">acidose <span class="blank _13"> </span>metabólica <span class="blank _13"> </span>hipercl<span class="blank _0"></span>orêmica <span class="blank _13"> </span>com <span class="blank _13"> </span>óbito <span class="blank _e"> </span>do </div><div class="t m0 x9 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">concepto. </div><div class="t m0 x9 h4 y4b ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Relacionadas <span class="blank _7"> </span>às<span class="blank _1"> </span> <span class="blank _7"> </span>gorduras <span class="blank _9"> </span>- <span class="blank _7"> </span>a <span class="blank _10"> </span>g<span class="blank _1"> </span>ordura <span class="blank _7"> </span>pode <span class="blank _10"> </span>causa<span class="blank _1"> </span>r </span></div><div class="t m0 x9 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">contração <span class="blank _12"> </span>uterina <span class="blank _14"> </span>em <span class="blank _12"> </span>decorrência <span class="blank _12"> </span>do <span class="blank _14"> </span>aumento <span class="blank _12"> </span>na </div><div class="t m0 x9 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3">síntese de ácido araquidônico, a partir do ácido linoléico, </div><div class="t m0 x9 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">antecipando o trabalho de parto. </div><div class="t m0 x9 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">Relacionadas às vitaminas e oligoelementos: </div><div class="t m0 x9 h4 y50 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Carência <span class="blank _4"> </span>de <span class="blank _4"> </span>zinco <span class="blank _4"> </span>- <span class="blank _4"> </span>anorexia, <span class="blank _4"> </span>diarreia, <span class="blank _a"> </span>al<span class="blank _1"> </span>opecia, </span></div><div class="t m0 x9 h4 y51 ff2 fs2 fc0 sc0 ls7 ws3">dermatite facial e retardo de cicatrização. </div><div class="t m0 x9 h4 y52 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Carência <span class="blank _15"> </span>de <span class="blank _15"> </span>cobre <span class="blank _15"> </span>- <span class="blank _15"> </span>anemia, <span class="blank _15"> </span>leucopenia, </span></div><div class="t m0 x9 h4 y53 ff2 fs2 fc0 sc0 ls7 ws3">desmielinização, <span class="blank _a"> </span>degeneração <span class="blank _a"> </span>do <span class="blank _a"> </span>s<span class="blank _1"> </span>istema <span class="blank _5"> </span>n<span class="blank _1"> </span>ervoso <span class="blank _5"> </span>e </div><div class="t m0 x9 h4 y54 ff2 fs2 fc0 sc0 ls7 ws3">alterações cardiovasculares. </div><div class="t m0 x9 h4 y55 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Carência <span class="blank _7"> </span>de <span class="blank _10"> </span>manganês <span class="blank _10"> </span>- <span class="blank _10"> </span>dermatite, <span class="blank _7"> </span>pe<span class="blank _1"> </span>rda <span class="blank _7"> </span>de <span class="blank _7"> </span>peso, </span></div><div class="t m0 x9 h4 y56 ff2 fs2 fc0 sc0 ls7 ws3">náusea e vômito. </div><div class="t m0 x9 h4 y57 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Excesso <span class="blank"> </span>de <span class="blank"> </span>vitamina<span class="blank _1"> </span> <span class="blank"> </span>D <span class="blank"> </span>-<span class="blank _1"> </span> <span class="blank"> </span>hipercalcemia <span class="blank"> </span>feta<span class="blank _1"> </span>l <span class="blank"> </span>com </span></div><div class="t m0 x9 h4 y58 ff2 fs2 fc0 sc0 ls7 ws3">retardo <span class="blank _7"> </span>de <span class="blank _7"> </span>crescimento, <span class="blank _7"> </span>e<span class="blank _0"></span>stenose <span class="blank _7"> </span>aórtica <span class="blank _7"> </span>e <span class="blank _7"> </span>depósito <span class="blank _2"> </span>de </div><div class="t m0 x9 h4 y59 ff2 fs2 fc0 sc0 ls7 ws3">cálcio no cérebro e em outros órgãos. </div><div class="t m0 x9 h4 y5a ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Excesso <span class="blank _10"> </span>de <span class="blank _9"> </span>vitamina <span class="blank _10"> </span>A <span class="blank _9"> </span>- <span class="blank _10"> </span>l<span class="blank _1"> </span>esão <span class="blank _7"> </span>o<span class="blank _1"> </span>bstrutiva <span class="blank _10"> </span>do <span class="blank _10"> </span>uretér </span></div><div class="t m0 x9 h4 y5b ff2 fs2 fc0 sc0 ls7 ws3">fetal <span class="blank _3"> </span>e <span class="blank _8"> </span>má <span class="blank"> </span>form<span class="blank _0"></span>ação <span class="blank _3"> </span>do <span class="blank _8"> </span>trato <span class="blank _3"> </span>urinário, <span class="blank _3"> </span>podendo <span class="blank _8"> </span>ainda </div><div class="t m0 x9 h4 y5c ff2 fs2 fc0 sc0 ls7 ws3">estar associada a defeitos do tubo neural. </div><div class="t m0 x9 h4 y5d ff2 fs2 fc0 sc0 ls4 ws3"> <span class="ls7 v2">Alterações <span class="blank _13"> </span>hepáticas <span class="blank _13"> </span>- <span class="blank _e"> </span>s<span class="blank _1"> </span>ão <span class="blank _e"> </span>mais <span class="blank _13"> </span>intensas <span class="blank _13"> </span>e </span></div><div class="t m0 x9 h4 y5e ff2 fs2 fc0 sc0 ls7 ws3">frequentes <span class="blank _7"> </span>do <span class="blank _7"> </span>que <span class="blank _7"> </span>fora <span class="blank _7"> </span>da <span class="blank _7"> </span>gravidez, <span class="blank _7"> </span>manifestam-se <span class="blank _7"> </span>por </div><div class="t m0 x9 h4 y5f ff2 fs2 fc0 sc0 ls7 ws3">aumento <span class="blank _16"> </span>das <span class="blank _16"> </span>transaminases <span class="blank _16"> </span>glutâmico-pirúvica <span class="blank _16"> </span>e </div><div class="t m0 x9 h4 y60 ff2 fs2 fc0 sc0 ls7 ws3">glutâmico-oxalacética, <span class="blank _16"> </span>a <span class="blank _16"> </span>fosfatase <span class="blank _16"> </span>alcalina <span class="blank _17"> </span>e <span class="blank _17"> </span>as </div><div class="t m0 x9 h4 y61 ff2 fs2 fc0 sc0 ls7 ws3">bilirrubinas <span class="blank _11"> </span>também <span class="blank _11"> </span>poderão <span class="blank _11"> </span>estar <span class="blank _11"> </span>e<span class="blank _0"></span>levadas. <span class="blank _11"> </span>Tais<span class="blank _0"></span> </div><div class="t m0 x9 h4 y62 ff2 fs2 fc0 sc0 ls7 ws3">alterações desaparecem <span class="blank _1"> </span>10 a 15 <span class="blank _1"> </span>dias após a <span class="blank _1"> </span>suspensão </div><div class="t m0 x9 h4 y63 ff2 fs2 fc0 sc0 ls7 ws3">da NPT<span class="ff1">. </span></div><div class="t m0 xa h4 y64 ff2 fs2 fc1 sc0 ls7 ws3"> </div><div class="t m0 xa h4 y65 ff2 fs2 fc0 sc0 ls7 ws3">Dan 17: </div><div class="t m0 xa h4 y66 ff2 fs2 fc0 sc0 ls7 ws3">Quando <span class="blank _d"> </span>ocorre <span class="blank _d"> </span>o <span class="blank _d"> </span>aumento <span class="blank _d"> </span>do <span class="blank _d"> </span>apetite <span class="blank _d"> </span>(mais <span class="blank _d"> </span>ou </div><div class="t m0 x9 h4 y67 ff2 fs2 fc0 sc0 ls7 ws3">menos <span class="blank"> </span>12 <span class="blank"> </span>dias) <span class="blank"> </span>a <span class="blank"> </span>dieta <span class="blank"> </span>e<span class="blank _0"></span>nteral <span class="blank"> </span>é <span class="blank"> </span>descontinuada <span class="blank _3"> </span>e <span class="blank"> </span>a </div><div class="t m0 x9 h4 y68 ff2 fs2 fc0 sc0 ls7 ws3">ingestão <span class="blank _5"> </span>oral <span class="blank _5"> </span>aumentada <span class="blank _5"> </span>gradati<span class="blank _1"> </span>vamente <span class="blank _6"> </span>até <span class="blank _5"> </span>que <span class="blank _5"> </span>se </div><div class="t m0 x9 h4 y69 ff2 fs2 fc0 sc0 ls7 ws3">possa <span class="blank _7"> </span>retirar <span class="blank _2"> </span>a <span class="blank _7"> </span>sonda <span class="blank _7"> </span>enteral <span class="blank _2"> </span>(mais <span class="blank _7"> </span>ou <span class="blank _7"> </span>menos <span class="blank _7"> </span>15 <span class="blank _2"> </span>dias). </div><div class="t m0 x9 h4 y6a ff2 fs2 fc0 sc0 ls7 ws3">Contraindicação <span class="blank _4"> </span>da <span class="blank _d"> </span>nutrição <span class="blank _4"> </span>enteral: <span class="blank _4"> </span>pe<span class="blank _1"> </span>rsistência <span class="blank _4"> </span>de </div><div class="t m0 x9 h4 y6b ff2 fs2 fc0 sc0 ls7 ws3">náuseas e vômitos (risco de aspiração). </div><div class="t m0 xa h4 y6c ff2 fs2 fc0 sc0 ls7 ws3">Em <span class="blank _8"> </span>casos <span class="blank _8"> </span>d<span class="blank _1"> </span>e <span class="blank _9"> </span>hipe<span class="blank _1"> </span>rêmese <span class="blank _9"> </span>grave, <span class="blank _8"> </span>a <span class="blank _8"> </span>via <span class="blank _8"> </span>n<span class="blank _1"> </span>asojejunal </div><div class="t m0 x9 h4 y6d ff2 fs2 fc0 sc0 ls7 ws3">deve <span class="blank _c"> </span>ser <span class="blank _c"> </span>a <span class="blank _c"> </span>de <span class="blank _c"> </span>escolha, <span class="blank _c"> </span>mas <span class="blank _c"> </span>se <span class="blank _c"> </span>houver <span class="blank _d"> </span>ri<span class="blank _1"> </span>sco <span class="blank _c"> </span>de<span class="blank _0"></span> </div><div class="t m0 x9 h4 y6e ff2 fs2 fc0 sc0 ls7 ws3">aspiração esta deve ser descontinuada. </div><div class="t m0 xb h4 y6f ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _6"> </span>nutrição <span class="blank _6"> </span>parenteral <span class="blank"> </span>p<span class="blank _1"> </span>ode <span class="blank"> </span>ser <span class="blank _6"> </span>o<span class="blank _1"> </span>ferecida <span class="blank _6"> </span>via </div><div class="t m0 x9 h4 y70 ff2 fs2 fc0 sc0 ls7 ws3">periférica <span class="blank _1"> </span>(pois <span class="blank _1"> </span>o <span class="blank _1"> </span>quadro <span class="blank _1"> </span>s<span class="blank _1"> </span>e <span class="blank _1"> </span>resolve <span class="blank _1"> </span>em <span class="blank _1"> </span>2 <span class="blank _1"> </span>a <span class="blank _1"> </span>3 <span class="blank _1"> </span>semanas). </div><div class="t m0 x9 h4 y71 ff2 fs2 fc0 sc0 ls7 ws3">Em casos <span class="blank _1"> </span>muito graves deve<span class="blank _1"> </span>-se usar <span class="blank _1"> </span>um acesso venoso </div><div class="t m0 x9 h4 y72 ff2 fs2 fc0 sc0 ls7 ws3">central, <span class="blank"> </span>mas<span class="blank _1"> </span> <span class="blank"> </span>as <span class="blank"> </span>chances <span class="blank"> </span>d<span class="blank _1"> </span>e <span class="blank"> </span>complicações <span class="blank"> </span>são <span class="blank _6"> </span>muito </div><div class="t m0 x9 h4 y73 ff2 fs2 fc0 sc0 ls7 ws3">maiores (infecções e tromboembolismos). </div><div class="t m0 x9 h4 y74 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y75 ff2 fs2 fc0 sc0 ls7 ws3">Composição da NPT: </div><div class="t m0 x9 h4 y76 ff2 fs2 fc0 sc0 ls7 ws3">- 40 a 50% de carboidratos </div><div class="t m0 x9 h4 y77 ff2 fs2 fc0 sc0 ls7 ws3">- 20 a 30% de lipídios </div><div class="t m0 x9 h4 y78 ff2 fs2 fc0 sc0 ls7 ws3">- 15 a 20% de proteínas </div><div class="t m0 x9 h4 y79 ff2 fs2 fc0 sc0 ls5 ws3"> <span class="ls7 v3">Atenção em<span class="blank _1"> </span> relação a <span class="blank _1"> </span>oferta de ca<span class="blank _1"> </span>rboidratos na </span></div><div class="t m0 x9 h4 y7a ff2 fs2 fc0 sc0 ls7 ws3">NPT <span class="blank _3"> </span><span class="ff5 ws2">\uf0e0</span> <span class="blank _3"> </span>efeito <span class="blank"> </span>diabetogêni<span class="blank _0"></span>co <span class="blank"> </span>da <span class="blank _8"> </span>gestação! <span class="blank"> </span>Assim <span class="blank _8"> </span>não </div><div class="t m0 x9 h4 y7b ff2 fs2 fc0 sc0 ls7 ws3">deve-se exceder 5 mg/kg/min. </div><div class="t m0 x9 h4 y7c ff2 fs2 fc0 sc0 ls7 ws3"> <span class="blank _18"> </span>As <span class="blank _6"> </span>soluções <span class="blank _6"> </span>aminoácido <span class="blank _6"> </span>padrão <span class="blank _6"> </span>atendem<span class="blank _1"> </span> <span class="blank"> </span>as </div><div class="t m0 x9 h4 y7d ff2 fs2 fc0 sc0 ls7 ws3">necessidades, <span class="blank _10"> </span>bem <span class="blank _7"> </span>como <span class="blank _10"> </span>as <span class="blank _7"> </span>emulsões <span class="blank _10"> </span>lipídi<span class="blank _1"> </span>cas. <span class="blank _7"> </span>Deve-</div><div class="t m0 x9 h4 y7e ff2 fs2 fc0 sc0 ls7 ws3">se <span class="blank _9"> </span>atentar <span class="blank _9"> </span>para <span class="blank _9"> </span>o <span class="blank _9"> </span>fornecimento <span class="blank _9"> </span>de<span class="blank _1"> </span> <span class="blank _10"> </span>4% <span class="blank _8"> </span>de <span class="blank _9"> </span>calorias <span class="blank _9"> </span>em </div><div class="t m0 x9 h4 y7f ff2 fs2 fc0 sc0 ls7 ws3">forma de EPA. </div><div class="t m0 xb h4 y80 ff2 fs2 fc0 sc0 ls7 ws3">São <span class="blank _e"> </span>relatadas <span class="blank _e"> </span>deficiências <span class="blank _e"> </span>subclínicas<span class="blank _1"> </span> <span class="blank _e"> </span>de </div><div class="t m0 x9 h4 y81 ff2 fs2 fc0 sc0 ls7 ws3">magnésio, <span class="blank _6"> </span>zinco, <span class="blank _5"> </span>fosfato, <span class="blank _6"> </span>ferro, <span class="blank _6"> </span>ác<span class="blank _1"> </span>ido <span class="blank _6"> </span>fólico, <span class="blank _6"> </span>vitamina </div><div class="t m0 x9 h4 y82 ff2 fs2 fc0 sc0 ls7 ws3">B12 <span class="blank _3"> </span>em <span class="blank _8"> </span>p<span class="blank _1"> </span>acientes <span class="blank _8"> </span>em <span class="blank"> </span>l<span class="blank _0"></span>ongos <span class="blank _3"> </span>períodos <span class="blank _8"> </span>de <span class="blank"> </span>parenteral<span class="blank _0"></span>. </div><div class="t m0 x9 h4 y83 ff2 fs2 fc0 sc0 ls7 ws3">Atentar para ofertas adicionais de cálcio e vitamina D. </div><div class="t m0 xb h4 y84 ff2 fs2 fc1 sc0 ls7 ws3"> </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi x1 y85 w6 ha" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg2.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">287 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y86 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y87 ff3 fs2 fc0 sc0 ls7 ws3">QUESTÕES: </div><div class="t m0 x1 hb y88 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">1) <span class="blank _6"> </span>A <span class="blank _6"> </span>transferência <span class="blank _6"> </span>de <span class="blank _6"> </span>nutrientes <span class="blank _6"> </span>p<span class="blank _1"> </span>ela <span class="blank"> </span>placenta <span class="blank _6"> </span>é <span class="blank _6"> </span>um </div><div class="t m0 x1 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">processo <span class="blank _7"> </span>complex<span class="blank _0"></span>o. <span class="blank _2"> </span>O <span class="blank _7"> </span>transporte <span class="blank _7"> </span>ativo <span class="blank _2"> </span>exige <span class="blank _7"> </span>tanto <span class="blank _2"> </span>uma </div><div class="t m0 x1 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">proteína <span class="blank _9"> </span>trans<span class="blank _1"> </span>portadora <span class="blank _10"> </span>c<span class="blank _1"> </span>omo <span class="blank _9"> </span>energia <span class="blank _8"> </span>metabólica <span class="blank _9"> </span>para </div><div class="t m0 x1 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">movimentar <span class="blank _19"> </span>um <span class="blank _19"> </span>nutriente<span class="blank _0"></span> <span class="blank _19"> </span>contra <span class="blank _19"> </span>um <span class="blank _19"> </span>gradiente<span class="blank _0"></span> </div><div class="t m0 x1 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3">eletroquímico. <span class="blank"> </span>As <span class="blank _3"> </span>substâncias <span class="blank _3"> </span>que <span class="blank _3"> </span>cruzam <span class="blank _8"> </span>a <span class="blank"> </span>placenta </div><div class="t m0 x1 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">através desse mecanismo são (UERJ): </div><div class="t m0 x1 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">(A) Oxigênio, ácidos graxos, cálcio e fósforo </div><div class="t m0 x1 h4 y89 ff2 fs2 fc0 sc0 ls7 ws3">(B) Aminoácidos, ácidos graxos, cálcio e fósforo </div><div class="t m0 x1 h4 y8a ff2 fs2 fc0 sc0 ls7 ws3">(C) Aminoácidos, vitaminas hidrossolúveis, cálcio e ferro </div><div class="t m0 x1 h4 y8b ff2 fs2 fc0 sc0 ls7 ws3">(D) <span class="blank"> </span>Oxigênio, <span class="blank _6"> </span>vitaminas <span class="blank"> </span>hidrossolúveis <span class="blank _6"> </span>aminoácidos <span class="blank"> </span>e </div><div class="t m0 x1 h4 y8c ff2 fs2 fc0 sc0 ls7 ws3">ferro </div><div class="t m0 x1 h4 y8d ff2 fs2 fc0 sc0 ls7 ws3">(E) <span class="blank _7"> </span>Vitaminas <span class="blank _2"> </span>hi<span class="blank _1"> </span>drossolúveis, <span class="blank _2"> </span>glicose, <span class="blank _7"> </span>oxigênio <span class="blank _2"> </span>e <span class="blank _7"> </span>ácidos </div><div class="t m0 x1 h4 y8e ff2 fs2 fc0 sc0 ls7 ws3">graxos </div><div class="t m0 x1 h4 y8f ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hc y90 ff1 fs5 fc0 sc0 ls7 ws3">2) <span class="blank _1a"> </span>Define-se <span class="blank _1a"> </span>Pica <span class="blank _1a"> </span>como <span class="blank _1a"> </span>a <span class="blank _1a"> </span>ingestão <span class="blank _1a"> </span>persistente <span class="blank _1a"> </span>de </div><div class="t m0 x1 hc y91 ff1 fs5 fc0 sc0 ls7 ws3">substâncias <span class="blank _6"> </span>n<span class="blank _1"> </span>ão <span class="blank _6"> </span>nu<span class="blank _1"> </span>tritivas. <span class="blank _6"> </span>Esse <span class="blank _6"> </span>transtorn<span class="blank _1"> </span>o <span class="blank _6"> </span>é <span class="blank _6"> </span>pr<span class="blank _1"> </span>oposto </div><div class="t m0 x1 hc y92 ff1 fs5 fc0 sc0 ls7 ws3">como <span class="blank _1a"> </span>um <span class="blank _11"> </span>quadro <span class="blank _1a"> </span>d<span class="blank _1"> </span>e <span class="blank _1a"> </span>TOC <span class="blank _11"> </span><span class="ff6 ws4">\u2013</span> <span class="blank _1a"> </span>transtorno<span class="blank _1"> </span> <span class="blank _1a"> </span>obsessivo </div><div class="t m0 x1 hc y93 ff1 fs5 fc0 sc0 ls7 ws3">compulsivo, e como u<span class="blank _1"> </span>ma prática </div><div class="t m0 x1 hc y94 ff1 fs5 fc0 sc0 ls7 ws3">que <span class="blank _2"> </span>leva <span class="blank _7"> </span>a <span class="blank _2"> </span>um <span class="blank _2"> </span>alívio <span class="blank _7"> </span>da <span class="blank _2"> </span>tensão <span class="blank _2"> </span>e <span class="blank _7"> </span>da <span class="blank _2"> </span>ansiedade. <span class="blank _7"> </span>Sugere-se </div><div class="t m0 x1 hc y95 ff1 fs5 fc0 sc0 ls7 ws3">que <span class="blank _12"> </span>a <span class="blank _14"> </span>Pica <span class="blank _14"> </span>é <span class="blank _12"> </span>uma <span class="blank _12"> </span>manifestação <span class="blank _14"> </span>da <span class="blank _14"> </span>deficiência <span class="blank _12"> </span>de </div><div class="t m0 x1 hc y96 ff1 fs5 fc0 sc0 ls7 ws3">(Prefeitura RJ, 2019): </div><div class="t m0 x1 hc y97 ff1 fs5 fc0 sc0 ls7 ws3">(A) selênio </div><div class="t m0 x1 hc y98 ff1 fs5 fc0 sc0 ls7 ws3">(B) zinco </div><div class="t m0 x1 hc y99 ff1 fs5 fc0 sc0 ls7 ws3">(C) cobre </div><div class="t m0 x1 hc y9a ff1 fs5 fc0 sc0 ls7 ws3">(D) manganês </div><div class="t m0 x1 hc y9b ff1 fs5 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hc y9c ff1 fs5 fc0 sc0 ls7 ws3">3) <span class="blank _d"> </span><span class="ff6">Segund<span class="blank _1"> </span>o <span class="blank _d"> </span>os <span class="blank _c"> </span>\u201cProtocolos <span class="blank _d"> </span>do <span class="blank _c"> </span>Sistema <span class="blank _d"> </span>de <span class="blank _d"> </span>Vigilância<span class="blank _1"> </span> </span></div><div class="t m0 x1 hc y9d ff1 fs5 fc0 sc0 ls7 ws3">Alimentar <span class="blank _7"> </span>e <span class="blank _7"> </span>Nutricional <span class="blank _7"> </span><span class="ff6 ws4">\u2013</span><span class="ls9"> </span><span class="ff6">SISVAN <span class="blank _7"> </span>na <span class="blank _10"> </span>assistência <span class="blank _7"> </span>à <span class="blank _7"> </span>saúde\u201d </span></div><div class="t m0 x1 hc y23 ff1 fs5 fc0 sc0 ls7 ws3">(Brasil, 2008), <span class="blank _1"> </span>a deficiência de <span class="blank _1"> </span>ferro é <span class="blank _1"> </span>a causa <span class="blank _1"> </span>mais comum </div><div class="t m0 x1 hc y9e ff1 fs5 fc0 sc0 ls7 ws3">de <span class="blank _7"> </span>anemia <span class="blank _7"> </span>nutricional <span class="blank _7"> </span>seguida <span class="blank _2"> </span>d<span class="blank _1"> </span>a <span class="blank _7"> </span>anemia <span class="blank _2"> </span>megalob<span class="blank _1"> </span>lástica. </div><div class="t m0 x1 hc y9f ff1 fs5 fc0 sc0 ls7 ws3">A distribuição normal da </div><div class="t m0 x1 hc ya0 ff1 fs5 fc0 sc0 ls7 ws3">hemoglobina <span class="blank _9"> </span>na <span class="blank _9"> </span>gestante <span class="blank _10"> </span>var<span class="blank _1"> </span>ia <span class="blank _9"> </span>conforme <span class="blank _9"> </span>idade, <span class="blank _9"> </span>período </div><div class="t m0 x1 hc ya1 ff1 fs5 fc0 sc0 ls7 ws3">gestacional <span class="blank _10"> </span>e <span class="blank _10"> </span>prática <span class="blank _10"> </span>de <span class="blank _10"> </span>tabagismo. <span class="blank _7"> </span>Nesse <span class="blank _10"> </span>caso, <span class="blank _10"> </span>para <span class="blank _10"> </span>ser </div><div class="t m0 x1 hc ya2 ff1 fs5 fc0 sc0 ls7 ws3">considerada <span class="blank _1"> </span>como <span class="blank _1"> </span>anemia <span class="blank _1"> </span>grave, a <span class="blank _1"> </span>hemoglob<span class="blank _1"> </span>ina é<span class="blank _1"> </span> inferior<span class="blank _1"> </span> </div><div class="t m0 x1 hc ya3 ff1 fs5 fc0 sc0 ls7 ws3">a (Prefeitura RJ, 2019): </div><div class="t m0 x1 hc ya4 ff1 fs5 fc0 sc0 ls7 ws3">(A) 7 g/dL </div><div class="t m0 x1 hc ya5 ff1 fs5 fc0 sc0 ls7 ws3">(B) 11 g/dL </div><div class="t m0 x1 hc ya6 ff1 fs5 fc0 sc0 ls7 ws3">(C) 15 g/dL </div><div class="t m0 x1 hc ya7 ff1 fs5 fc0 sc0 ls7 ws3">(D) 20 g/dL </div><div class="t m0 x1 hc ya8 ff1 fs5 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hc ya9 ff1 fs5 fc0 sc0 ls7 ws3">4) <span class="blank _10"> </span><span class="ff6">Segun<span class="blank _1"> </span>do <span class="blank _10"> </span>o<span class="blank _1"> </span> <span class="blank _10"> </span>\u201cPrograma <span class="blank _9"> </span>Nacional <span class="blank _9"> </span>de <span class="blank _9"> </span>Suplementação <span class="blank _9"> </span>de </span></div><div class="t m0 x1 hc yaa ff1 fs5 fc0 sc0 ls7 ws3">Ferro: <span class="blank _e"> </span>manual <span class="blank _f"> </span>de <span class="blank _e"> </span>condutas <span class="blank _e"> </span>ge<span class="ff6">rais\u201d <span class="blank _e"> </span>(Brasil, <span class="blank _e"> </span>2013), </span></div><div class="t m0 x1 hc yab ff1 fs5 fc0 sc0 ls7 ws3">recomenda-se <span class="blank _1"> </span>a su<span class="blank _1"> </span>plementação <span class="blank _1"> </span>de <span class="blank _1"> </span>ferro <span class="blank _1"> </span>e á<span class="blank _1"> </span>cido fó<span class="blank _1"> </span>lico em<span class="blank _1"> </span> </div><div class="t m0 x1 hc yac ff1 fs5 fc0 sc0 ls7 ws3">grupos <span class="blank _2"> </span>específicos <span class="blank _1"> </span>como <span class="blank _2"> </span>crianças <span class="blank _2"> </span>e <span class="blank _1"> </span>gestantes. <span class="blank _2"> </span>Neste <span class="blank _2"> </span>caso, </div><div class="t m0 x1 hc yad ff1 fs5 fc0 sc0 ls7 ws3">a <span class="blank _d"> </span>suplementação <span class="blank _d"> </span>de <span class="blank _d"> </span>ferro<span class="blank _1"> </span> <span class="blank _d"> </span>e <span class="blank _d"> </span>ácido <span class="blank _d"> </span>fólico <span class="blank _d"> </span>tem <span class="blank _c"> </span>como </div><div class="t m0 x1 hc yae ff1 fs5 fc0 sc0 ls7 ws3">conduta <span class="blank _d"> </span>administrar, <span class="blank _d"> </span>respectivamente, <span class="blank _d"> </span>até <span class="blank _d"> </span>o <span class="blank _d"> </span>final <span class="blank _4"> </span>d<span class="blank _1"> </span>a </div><div class="t m0 x1 hc yaf ff1 fs5 fc0 sc0 ls7 ws3">gestação (Prefeitura RJ, 2019):<span class="blank _1"> </span> </div><div class="t m0 x1 hc yb0 ff1 fs5 fc0 sc0 ls7 ws3">(A) 10 mg de ferro elementar e 100 <span class="blank _1"> </span><span class="ff6">\u03bcg de ácido fólico</span> </div><div class="t m0 x1 hc yb1 ff6 fs5 fc0 sc0 ls7 ws3">(B) 20 mg de ferro elementar e 200 \u03bcg de ácido fólico<span class="blank _1"> </span><span class="ff1"> </span></div><div class="t m0 x1 hc yb2 ff6 fs5 fc0 sc0 ls7 ws3">(C) 30 mg de ferro elementar e 300 \u03bcg de ácido fólico<span class="blank _1"> </span><span class="ff1"> </span></div><div class="t m0 x1 hc yb3 ff6 fs5 fc0 sc0 ls7 ws3">(D) 40 mg de ferro elementar e 400 \u03bcg de ácido fólico<span class="blank _1"> </span><span class="ff1"> </span></div><div class="t m0 x1 hc yb4 ff1 fs5 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 yb5 ff2 fs2 fc0 sc0 ls7 ws3">5) <span class="blank _1"> </span>Em <span class="blank _1"> </span>relação <span class="blank _1"> </span>à <span class="blank _1"> </span>suplementação de <span class="blank _1"> </span>vitaminas <span class="blank _1"> </span>e <span class="blank _1"> </span>minerais </div><div class="t m0 x1 h4 yb6 ff2 fs2 fc0 sc0 ls7 ws3">na <span class="blank _6"> </span>gestação <span class="blank _6"> </span>de <span class="blank"> </span>adultas <span class="blank _6"> </span>e <span class="blank _6"> </span>adolescentes, <span class="blank"> </span>as <span class="blank _6"> </span>recentes </div><div class="t m0 x1 h4 yb7 ff2 fs2 fc0 sc0 ls7 ws3">recomendações <span class="blank _c"> </span>da <span class="blank _d"> </span>Organização <span class="blank _d"> </span>Mundial <span class="blank _c"> </span>da <span class="blank _c"> </span>Saú<span class="blank _0"></span>de </div><div class="t m0 x1 h4 yb8 ff2 fs2 fc0 sc0 ls7 ws3">(2016) <span class="blank _13"> </span>sobre <span class="blank _13"> </span>os <span class="blank _13"> </span>cuidados <span class="blank _13"> </span>pré-natais<span class="blank _1"> </span> <span class="blank _13"> </span>para <span class="blank _e"> </span>u<span class="blank _1"> </span>ma </div><div class="t m0 x1 h4 yb9 ff2 fs2 fc0 sc0 ls7 ws3">experiência <span class="blank _1b"> </span>positiva <span class="blank _1b"> </span>na <span class="blank _1c"> </span>gravidez <span class="blank _1c"> </span>p<span class="blank _1"> </span>reconizam </div><div class="t m0 x1 h4 yba ff2 fs2 fc0 sc0 ls7 ws3">(Residência Multiprofissional UFRJ, 2018)<span class="lsb">: </span> </div><div class="t m0 x1 h4 ybb ff2 fs2 fc0 sc0 ls7 ws3">a) <span class="blank _a"> </span>a <span class="blank _4"> </span>suplementação <span class="blank _a"> </span>d<span class="blank _1"> </span>e <span class="blank _a"> </span>múltiplos <span class="blank _4"> </span>micronutrientes <span class="blank _4"> </span>às </div><div class="t m0 x1 h4 ybc ff2 fs2 fc0 sc0 ls7 ws3">grávidas <span class="blank _14"> </span>para <span class="blank _12"> </span>melhorar <span class="blank _14"> </span>os <span class="blank _12"> </span>resultados <span class="blank _14"> </span>maternos <span class="blank _12"> </span>e </div><div class="t m0 x1 h4 ybd ff2 fs2 fc0 sc0 ls7 ws3">perinatais, <span class="blank _2"> </span>tais <span class="blank _2"> </span>como <span class="blank _2"> </span>prevenção <span class="blank _2"> </span>da <span class="blank _2"> </span>anemia <span class="blank _2"> </span>materna, <span class="blank _2"> </span>da </div><div class="t m0 x1 h4 ybe ff2 fs2 fc0 sc0 ls7 ws3">infecção puerperal e do baixo peso ao nascer. </div><div class="t m0 x9 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">b) <span class="blank _2"> </span>a <span class="blank _1"> </span>s<span class="blank _1"> </span>uplementação <span class="blank _1"> </span>diária <span class="blank _1"> </span>de<span class="blank _1"> </span> <span class="blank _1"> </span>ferro <span class="blank _2"> </span>e <span class="blank _2"> </span>ácido <span class="blank _2"> </span>fólico, <span class="blank _1"> </span>sendo </div><div class="t m0 x9 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">de <span class="blank _7"> </span>30 <span class="blank _10"> </span>mg <span class="blank _7"> </span>a <span class="blank _7"> </span>60 <span class="blank _7"> </span>m<span class="blank _1"> </span>g <span class="blank _7"> </span>de <span class="blank _7"> </span>ferro <span class="blank _7"> </span>elementa<span class="blank _1"> </span>r <span class="blank _7"> </span>e <span class="blank _7"> </span>de <span class="blank _7"> </span>400 <span class="blank _9"> </span>µg <span class="blank _7"> </span>de </div><div class="t m0 x9 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3">ácido <span class="blank _7"> </span>fólico <span class="blank _2"> </span>para <span class="blank _7"> </span>as <span class="blank _2"> </span>gestantes, <span class="blank _7"> </span>visando <span class="blank _2"> </span>a <span class="blank _7"> </span>prevenção <span class="blank _2"> </span>da </div><div class="t m0 x9 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">anemia <span class="blank _8"> </span>gestacional, <span class="blank _8"> </span>da <span class="blank _8"> </span>infecção <span class="blank _8"> </span>puerperal <span class="blank _8"> </span>e <span class="blank _8"> </span>do <span class="blank _8"> </span>baixo </div><div class="t m0 x9 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">peso ao nascer e parto prematuro. </div><div class="t m0 x9 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">c) As <span class="blank _1"> </span>suplementações de <span class="blank _1"> </span>vitamina B6 <span class="blank _1"> </span>(piridoxina), C e <span class="blank _1"> </span>E </div><div class="t m0 x9 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">são <span class="blank _1a"> </span>recomendadas <span class="blank _14"> </span>na <span class="blank _1a"> </span>ges<span class="blank _0"></span>tação <span class="blank _1a"> </span>para <span class="blank _14"> </span>melhorar <span class="blank _14"> </span>a </div><div class="t m0 x9 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3">sintomatologia <span class="blank _11"> </span>digestiva <span class="blank _11"> </span>e <span class="blank _11"> </span>prevenir <span class="blank _11"> </span>as <span class="blank _11"> </span>Síndromes </div><div class="t m0 x9 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">Hipertensivas da Gravidez. </div><div class="t m0 x9 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">d) <span class="blank _7"> </span>O <span class="blank _2"> </span>uso <span class="blank _7"> </span>de <span class="blank _2"> </span>su<span class="blank _1"> </span>plemento <span class="blank _2"> </span>de <span class="blank _7"> </span>vitamina <span class="blank _2"> </span>D <span class="blank _7"> </span>é <span class="blank _2"> </span>re<span class="blank _1"> </span>comendado </div><div class="t m0 x9 h4 y50 ff2 fs2 fc0 sc0 ls7 ws3">durante <span class="blank _1"> </span>toda <span class="blank _1"> </span>a <span class="blank _1"> </span>gestação <span class="blank _1"> </span>para <span class="blank _1"> </span>prevenção <span class="blank _1"> </span>da <span class="blank _1"> </span>cárie <span class="blank _1"> </span>dental </div><div class="t m0 x9 h4 y51 ff2 fs2 fc0 sc0 ls7 ws3">materna, <span class="blank _1a"> </span>hipertensão <span class="blank _1a"> </span>gestacional, <span class="blank _1a"> </span>e <span class="blank _1a"> </span>também <span class="blank _14"> </span>p<span class="blank _1"> </span>ara </div><div class="t m0 x9 h4 y52 ff2 fs2 fc0 sc0 ls7 ws3">melhorar o peso ao nascer. </div><div class="t m0 x9 h4 y53 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y54 ff2 fs2 fc0 sc0 ls7 ws3">6) <span class="blank _14"> </span>A <span class="blank _14"> </span>prevalência <span class="blank _14"> </span>de <span class="blank _12"> </span>c<span class="blank _1"> </span>egueira <span class="blank _12"> </span>noturna <span class="blank _14"> </span>gestacional </div><div class="t m0 x9 h4 y55 ff2 fs2 fc0 sc0 ls7 ws3">sugerida <span class="blank _12"> </span>para <span class="blank _12"> </span>definição <span class="blank _c"> </span>como <span class="blank _12"> </span>problema <span class="blank _12"> </span>de <span class="blank _c"> </span>s<span class="blank _1"> </span>aúde </div><div class="t m0 x9 h4 y56 ff4 fs2 fc0 sc0 ls7 ws3">pública é: (A) \u2265 5% (B) \u2265 10% (C) \u2265 15% (D) \u2265 20%<span class="ff2"> </span></div><div class="t m0 x9 h4 y57 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y58 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y59 ff2 fs2 fc0 sc0 ls7 ws3">7) <span class="blank _1"> </span>Dentre <span class="blank _1"> </span>os <span class="blank _1"> </span>efeitos <span class="blank _1"> </span>ad<span class="blank _1"> </span>versos do <span class="blank _1"> </span>c<span class="blank _1"> </span>onsumo <span class="blank _1"> </span>excessivo <span class="blank _1"> </span>de </div><div class="t m0 x9 h4 y5a ff2 fs2 fc0 sc0 ls7 ws3">bebidas <span class="blank _4"> </span>alcoólicas <span class="blank _d"> </span>na <span class="blank _4"> </span>gestação <span class="blank _4"> </span>no <span class="blank _d"> </span>desenvolvimento<span class="blank _0"></span> </div><div class="t m0 x9 h4 y5b ff2 fs2 fc0 sc0 ls7 ws3">fetal, podemos citar (UFRJ 2011): </div><div class="t m0 x9 h4 y5c ff2 fs2 fc0 sc0 ls7 ws3">(A) efeito tóxico para o feto e anomalias congênitas </div><div class="t m0 x9 h4 ybf ff2 fs2 fc0 sc0 ls7 ws3">(B) restrição do crescimento intra-uterino </div><div class="t m0 x9 h4 yc0 ff2 fs2 fc0 sc0 ls7 ws3">(C) síndrome alcoólica fetal </div><div class="t m0 x9 h4 yc1 ff2 fs2 fc0 sc0 ls7 ws3">(D) todas as opções estão corretas </div><div class="t m0 x9 h4 yc2 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 yc3 ff2 fs2 fc0 sc0 ls7 ws3">8) Vitolo <span class="blank _1"> </span>(2008) refere qu<span class="blank _1"> </span>e o uso <span class="blank _1"> </span>de edulcorantes e <span class="blank _1"> </span>chás </div><div class="t m0 x9 h4 yc4 ff2 fs2 fc0 sc0 ls7 ws3">durante <span class="blank"> </span>o <span class="blank _6"> </span>período <span class="blank"> </span>gestacional <span class="blank _6"> </span>deve <span class="blank"> </span>ser <span class="blank _6"> </span>baseado <span class="blank"> </span>em </div><div class="t m0 x9 h4 yc5 ff2 fs2 fc0 sc0 ls7 ws3">informações <span class="blank _7"> </span>cientificas. <span class="blank _7"> </span>Assinale <span class="blank _10"> </span>a <span class="blank _7"> </span>alternativa <span class="blank _7"> </span>correta <span class="blank _7"> </span>a </div><div class="t m0 x9 h4 yc6 ff2 fs2 fc0 sc0 ls7 ws3">respeito desse assunto (PMRJ 2010). </div><div class="t m0 x9 h4 yc7 ff2 fs2 fc0 sc0 ls7 ws3">(A) <span class="blank _1"> </span>O edulcorante <span class="blank _1"> </span>aspartame e <span class="blank _1"> </span>considerado <span class="blank _1"> </span>nocivo, pois </div><div class="t m0 x9 h4 yc8 ff2 fs2 fc0 sc0 ls7 ws3">a <span class="blank _1"> </span>presença <span class="blank _1"> </span>de <span class="blank _1"> </span>fenilalanina <span class="blank _1"> </span>em <span class="blank _1"> </span>grande <span class="blank _1"> </span>quantidade <span class="blank _1"> </span>causa </div><div class="t m0 x9 h4 yc9 ff2 fs2 fc0 sc0 ls7 ws3">dano neurológico do feto. </div><div class="t m0 x9 h4 yca ff2 fs2 fc0 sc0 ls7 ws3">(B) <span class="blank _7"> </span>O <span class="blank _7"> </span>edulcorante <span class="blank _7"> </span>acessulfame-K <span class="blank _7"> </span>e <span class="blank _7"> </span>um <span class="blank _7"> </span>sal <span class="blank _7"> </span>de <span class="blank _7"> </span>potassio </div><div class="t m0 x9 h4 ycb ff2 fs2 fc0 sc0 ls7 ws3">que <span class="blank _8"> </span>tem <span class="blank _3"> </span>estrutura <span class="blank _8"> </span>química <span class="blank _8"> </span>semelhante <span class="blank _3"> </span>a <span class="blank _8"> </span>da <span class="blank _8"> </span>sacarina, </div><div class="t m0 x9 h4 ycc ff2 fs2 fc0 sc0 ls7 ws3">por <span class="blank _4"> </span>isso <span class="blank _4"> </span>a <span class="blank _4"> </span>Associação <span class="blank _d"> </span>Am<span class="blank _0"></span>ericana <span class="blank _4"> </span>de <span class="blank _4"> </span>Die<span class="blank _1"> </span>tética <span class="blank _4"> </span>não </div><div class="t m0 x9 h4 ycd ff2 fs2 fc0 sc0 ls7 ws3">considera seu uso seguro. </div><div class="t m0 x9 h4 yce ff2 fs2 fc0 sc0 ls7 ws3">(C) <span class="blank"> </span>O <span class="blank"> </span>u<span class="blank _1"> </span>so <span class="blank"> </span>da <span class="blank"> </span>c<span class="blank _1"> </span>amomila <span class="blank"> </span>(<span class="blank _1"> </span><span class="ff7">Matricaria <span class="blank"> </span>chamomilla</span>) <span class="blank"> </span>esta </div><div class="t m0 x9 h4 ycf ff2 fs2 fc0 sc0 lsa ws5">liber<span class="ls7 ws3">ado, <span class="blank _a"> </span>no <span class="blank _a"> </span>período <span class="blank _a"> </span>gestacional, <span class="blank _a"> </span>pela <span class="blank _a"> </span>Secreta<span class="blank _1"> </span>ria <span class="blank _5"> </span>de </span></div><div class="t m0 x9 h4 yd0 ff2 fs2 fc0 sc0 ls7 ws3">Saúde do Estado do Rio de Janeiro. </div><div class="t m0 x9 h4 yd1 ff2 fs2 fc0 sc0 ls7 ws3">(D) <span class="blank _2"> </span>Os <span class="blank _2"> </span>chás <span class="blank _2"> </span>de <span class="blank _2"> </span>erva <span class="blank _2"> </span>doce <span class="blank _2"> </span>e <span class="blank _2"> </span>de <span class="blank _2"> </span>erva <span class="blank _2"> </span>ci<span class="blank _1"> </span>dreira, <span class="blank _1"> </span>apesar <span class="blank _2"> </span>de </div><div class="t m0 x9 h4 yd2 ff2 fs2 fc0 sc0 ls7 ws3">serem <span class="blank _7"> </span>utilizados <span class="blank _7"> </span>em <span class="blank _10"> </span>unidades <span class="blank _7"> </span>hospitalares, <span class="blank _7"> </span>nao <span class="blank _7"> </span>d<span class="blank _1"> </span>evem </div><div class="t m0 x9 h4 yd3 ff2 fs2 fc0 sc0 ls7 ws3">ser <span class="blank _8"> </span>usados <span class="blank _3"> </span>pelas <span class="blank _8"> </span>gestantes, <span class="blank _8"> </span>segundo <span class="blank _8"> </span>a <span class="blank"> </span>S<span class="blank _0"></span>ecretaria <span class="blank _8"> </span>de </div><div class="t m0 x9 h4 yd4 ff2 fs2 fc0 sc0 ls7 ws3">Saúde do Estado do Rio de Janeiro. </div><div class="t m0 x9 h4 yd5 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 yd6 ff2 fs2 fc0 sc0 ls7 ws3">9. Voc<span class="blank _1"> </span>ê está ate<span class="blank _1"> </span>ndendo uma gestante <span class="blank _1"> </span>saudável, com <span class="blank _1"> </span>28 </div><div class="t m0 x9 h4 yd7 ff2 fs2 fc0 sc0 ls7 ws3">anos <span class="blank _2"> </span>de <span class="blank _7"> </span>idad<span class="blank _0"></span>e, <span class="blank _2"> </span>estatura <span class="blank _7"> </span>= <span class="blank _2"> </span>1,65 <span class="blank _2"> </span>m. <span class="blank _2"> </span>A <span class="blank _7"> </span>gestante<span class="blank _0"></span> <span class="blank _2"> </span>não <span class="blank _7"> </span>sabe<span class="blank _0"></span> </div><div class="t m0 x9 h4 yd8 ff2 fs2 fc0 sc0 ls7 ws3">informar <span class="blank _17"> </span>o <span class="blank _17"> </span>p<span class="blank _1"> </span>eso <span class="blank _17"> </span>pré-gestacional<span class="blank _1"> </span>. <span class="blank _17"> </span>No <span class="blank _17"> </span>prontuário, </div><div class="t m0 x9 h4 yd9 ff2 fs2 fc0 sc0 ls7 ws3">observam-se <span class="blank _2"> </span>os<span class="blank _1"> </span> <span class="blank _2"> </span>seguintes <span class="blank _2"> </span>pesos <span class="blank _7"> </span>por <span class="blank _1"> </span>i<span class="blank _1"> </span>dade <span class="blank _2"> </span>gestacional: </div><div class="t m0 x9 h4 yda ff2 fs2 fc0 sc0 ls7 ws3">8 <span class="blank _1"> </span>semanas <span class="blank _1"> </span><span class="ff4 ls1">\u2013</span> 65 <span class="blank _1"> </span>kg; <span class="blank _1"> </span>14 <span class="blank _1"> </span>semanas <span class="blank _1"> </span><span class="ff4 ls1">\u2013</span> 66 <span class="blank _1"> </span>kg; <span class="blank _1"> </span>e 18 <span class="blank _1"> </span>semanas </div><div class="t m0 x9 h4 ydb ff4 fs2 fc0 sc0 ls1">\u2013<span class="ff2 ls7 ws3"> <span class="blank _7"> </span>69 <span class="blank _2"> </span>k<span class="blank _1"> </span>g. <span class="blank _7"> </span>A<span class="blank _0"></span>ssinale <span class="blank _7"> </span>a <span class="blank _2"> </span>a<span class="blank _1"> </span>lternativa <span class="blank _2"> </span>qu<span class="blank _1"> </span>e <span class="blank _2"> </span>c<span class="blank _1"> </span>ontem <span class="blank _7"> </span>o <span class="blank _2"> </span>ganho <span class="blank _7"> </span>de </span></div><div class="t m0 x9 h4 ydc ff2 fs2 fc0 sc0 ls7 ws3">peso <span class="blank _6"> </span>semanal <span class="blank _5"> </span>restante <span class="blank _6"> </span>adequado <span class="blank _6"> </span>até <span class="blank _5"> </span>a <span class="blank _6"> </span>40ª <span class="blank _6"> </span>semana </div><div class="t m0 x9 h4 ydd ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank _9"> </span>e <span class="blank _8"> </span>um <span class="blank _9"> </span>valor <span class="blank _8"> </span>energético <span class="blank _9"> </span>total <span class="blank _9"> </span>(VET) <span class="blank _8"> </span>de <span class="blank _9"> </span>uma </div><div class="t m0 x9 h4 yde ff2 fs2 fc0 sc0 ls7 ws3">dieta <span class="blank _d"> </span>que <span class="blank _4"> </span>p<span class="blank _1"> </span>romova <span class="blank _4"> </span>este <span class="blank _d"> </span>ganho <span class="blank _d"> </span>de <span class="blank _4"> </span>peso<span class="blank _1"> </span>. <span class="blank _d"> </span>(Para <span class="blank _4"> </span>os </div><div class="t m0 x9 h4 ydf ff2 fs2 fc0 sc0 ls7 ws3">cálculos, <span class="blank _d"> </span>considere <span class="blank _d"> </span>os <span class="blank _d"> </span>dados <span class="blank _d"> </span>fornecidos <span class="blank _d"> </span>no <span class="blank _4"> </span>qu<span class="blank _1"> </span>adro </div><div class="t m0 x9 h4 ye0 ff2 fs2 fc0 sc0 ls7 ws3">abaixo).(Residência Multiprofissional <span class="ff4 ls1">\u2013</span> UFRJ, 2015): </div><div class="t m0 x9 h4 ye1 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 ye2 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 hd ye3 ff2 fs6 fc0 sc0 ls7 ws6">(<span class="fs2 ws3">A) 330 g/semana; VET = 2621 kcal/dia. </span></div><div class="t m0 x9 h4 ye4 ff2 fs2 fc0 sc0 ls7 ws3">(B) 400 g/semana; VET = 2685 kcal/dia. </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1 ye5 w7 he" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg3.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">288 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">(C) 350 g/semana; VET = 2734 kcal/dia. </div><div class="t m0 x1 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">(D) 380 g/semana; VET = 2761 kcal/dia </div><div class="t m0 x1 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">10) <span class="blank _6"> </span>Você <span class="blank _5"> </span>está <span class="blank _6"> </span>atendendo <span class="blank _6"> </span>uma <span class="blank _5"> </span>gestante <span class="blank _6"> </span>adulta, <span class="blank _6"> </span>com </div><div class="t m0 x1 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">eutrofia <span class="blank _1"> </span>pré-gestacional <span class="blank _1"> </span>e <span class="blank _1"> </span>hoje <span class="blank _1"> </span>está c<span class="blank _1"> </span>om <span class="blank _1"> </span>23 semanas <span class="blank _1"> </span>de </div><div class="t m0 x1 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">gestação <span class="blank _7"> </span>e<span class="blank _0"></span> <span class="blank _7"> </span>um <span class="blank _2"> </span>resultado <span class="blank _2"> </span>de <span class="blank _7"> </span>hemoglobina <span class="blank _2"> </span>de <span class="blank _2"> </span>10,2 <span class="blank _7"> </span>g/dL. </div><div class="t m0 x1 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _5"> </span>ge<span class="blank _1"> </span>stante <span class="blank _5"> </span>apresen<span class="blank _1"> </span>ta <span class="blank _5"> </span>(Res<span class="blank _1"> </span>idência <span class="blank _5"> </span>Multiprofissional <span class="blank _a"> </span><span class="ff4 ws7">\u2013</span> </div><div class="t m0 x1 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3">UFRJ, 2014)<span class="lsb">: </span> </div><div class="t m0 x1 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">a) <span class="blank _19"> </span>não <span class="blank _1d"> </span>apresenta <span class="blank _1d"> </span>anemia, <span class="blank _1d"> </span>e<span class="blank _1"> </span>ntretanto, <span class="blank _1d"> </span>deve<span class="blank _1"> </span>-se </div><div class="t m0 x1 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">prescrever <span class="blank _2"> </span>dose <span class="blank _2"> </span>profilática <span class="blank _2"> </span>de <span class="blank _2"> </span>60 <span class="blank _2"> </span>mg <span class="blank _2"> </span>de <span class="blank _2"> </span>ferro <span class="blank _2"> </span>elementar </div><div class="t m0 x1 h4 y50 ff2 fs2 fc0 sc0 ls7 ws3">por dia. </div><div class="t m0 x1 h4 y51 ff2 fs2 fc0 sc0 ls7 ws3">b) <span class="blank _9"> </span>an<span class="blank _1"> </span>emia <span class="blank _9"> </span>e <span class="blank _9"> </span>d<span class="blank _1"> </span>eve <span class="blank _9"> </span>ser <span class="blank _8"> </span>tratada <span class="blank _9"> </span>com <span class="blank _8"> </span>120 <span class="blank _9"> </span>mg <span class="blank _8"> </span>de <span class="blank _9"> </span>s<span class="blank _1"> </span>ulfato<span class="blank _0"></span> </div><div class="t m0 x1 h4 y52 ff2 fs2 fc0 sc0 ls7 ws3">ferroso por dia </div><div class="t m0 x1 h4 y53 ff2 fs2 fc0 sc0 ls7 ws3">c) <span class="blank _2"> </span>apresen<span class="blank _1"> </span>ta <span class="blank _1"> </span>a<span class="blank _1"> </span>nemia <span class="blank _2"> </span>grave <span class="blank _2"> </span>e <span class="blank _2"> </span>deve <span class="blank _7"> </span>ser <span class="blank _2"> </span>encaminhada <span class="blank _2"> </span>ao </div><div class="t m0 x1 h4 y54 ff2 fs2 fc0 sc0 ls7 ws3">pré-natal de alto risco </div><div class="t m0 x1 h4 y55 ff2 fs2 fc0 sc0 ls7 ws3">d) anemia <span class="blank _1"> </span>e deve ser tra<span class="blank _1"> </span>tada com 120 a 240 m<span class="blank _1"> </span>g de fe<span class="blank _1"> </span>rro<span class="blank _0"></span> </div><div class="t m0 x1 h4 y56 ff2 fs2 fc0 sc0 ls7 ws3">elementar por dia </div><div class="t m0 x1 h4 y57 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y58 ff2 fs2 fc0 sc0 ls7 ws3">11) A <span class="blank _1"> </span>recomendação de ingestão <span class="blank _1"> </span>dietética de vitamina A </div><div class="t m0 x1 h4 y59 ff2 fs2 fc0 sc0 ls7 ws3">durante <span class="blank _9"> </span>a <span class="blank _9"> </span>gestação <span class="blank _8"> </span>e <span class="blank _9"> </span>lactação, <span class="blank _9"> </span>para <span class="blank _8"> </span>mulheres <span class="blank _9"> </span>adultas </div><div class="t m0 x1 h4 y5a ff2 fs2 fc0 sc0 ls7 ws3">de <span class="blank _a"> </span>19 <span class="blank _4"> </span>a <span class="blank _a"> </span>50 <span class="blank _a"> </span>anos<span class="blank _1"> </span>, <span class="blank _a"> </span>são <span class="blank _a"> </span>respectivamente<span class="blank _1"> </span> <span class="blank _a"> </span>(Residência </div><div class="t m0 x1 h4 y5b ff2 fs2 fc0 sc0 ls7 ws3">Multiprofissional <span class="ff4 ls1">\u2013</span> UFRJ, 2012)<span class="lsb">: </span> </div><div class="t m0 x1 h4 y5c ff2 fs2 fc0 sc0 ls7 ws3">a) 750 µgRE/dia e 1200 µgRE/dia </div><div class="t m0 x1 h4 y5d ff2 fs2 fc0 sc0 ls7 ws3">b) 770 µgRE/dia e 1200 µgRE/dia </div><div class="t m0 x1 h4 ye6 ff2 fs2 fc0 sc0 ls7 ws3">c) 770 µgRE/dia e 1300 µgRE/dia </div><div class="t m0 x1 h4 y5e ff2 fs2 fc0 sc0 ls7 ws3">d) 750 µgRE/dia e 1300 µgRE/dia </div><div class="t m0 x1 h4 y5f ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y60 ff2 fs2 fc0 sc0 ls7 ws3">12) <span class="blank _d"> </span>O <span class="blank _d"> </span>Institute <span class="blank _d"> </span>of <span class="blank _d"> </span>Medicine <span class="blank _4"> </span>(IOM, <span class="blank _d"> </span>2009) <span class="blank _d"> </span>revisou <span class="blank _d"> </span>e </div><div class="t m0 x1 h4 y61 ff2 fs2 fc0 sc0 ls7 ws3">publicou <span class="blank _7"> </span>em <span class="blank _7"> </span>2009, <span class="blank _7"> </span>a <span class="blank _7"> </span>recomendação <span class="blank _7"> </span>de <span class="blank _7"> </span>ganho<span class="blank _1"> </span> <span class="blank _7"> </span>de <span class="blank _7"> </span>peso </div><div class="t m0 x1 h4 y62 ff2 fs2 fc0 sc0 ls7 ws3">durante <span class="blank _17"> </span>a <span class="blank _17"> </span>ge<span class="blank _1"> </span>stação <span class="blank _17"> </span>para <span class="blank _17"> </span>mulheres <span class="blank _17"> </span>americanas. </div><div class="t m0 x1 h4 ye7 ff2 fs2 fc0 sc0 ls7 ws3">Segundo <span class="blank _f"> </span>a <span class="blank _f"> </span>nova <span class="blank _e"> </span>proposta <span class="blank _f"> </span>é <span class="blank _e"> </span>CORRET<span class="blank _0"></span>O <span class="blank _f"> </span>afirmar </div><div class="t m0 x1 h4 ye8 ff2 fs2 fc0 sc0 ls7 ws3">(Residência Multiprofissional <span class="ff4 ws7">\u2013</span> UFRJ, 2014)<span class="lsb">: </span> </div><div class="t m0 x1 h4 ye9 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 yea ff2 fs2 fc0 sc0 ls7 ws3">a) <span class="blank _7"> </span>a <span class="blank _10"> </span>faixa <span class="blank _7"> </span>de <span class="blank _10"> </span>ganho <span class="blank _10"> </span>de <span class="blank _7"> </span>p<span class="blank _1"> </span>eso <span class="blank _7"> </span>total <span class="blank _10"> </span>foi <span class="blank _10"> </span>reduzida <span class="blank _7"> </span>para <span class="blank _10"> </span>as </div><div class="t m0 x1 h4 y9e ff2 fs2 fc0 sc0 ls7 ws3">mulheres <span class="blank _f"> </span>com<span class="blank _1"> </span> <span class="blank _f"> </span>obesidade <span class="blank _f"> </span>e <span class="blank _e"> </span>aumentada <span class="blank _f"> </span>para <span class="blank _e"> </span>as </div><div class="t m0 x1 h4 yeb ff2 fs2 fc0 sc0 ls7 ws3">mulheres com baixo peso </div><div class="t m0 x1 h4 yec ff2 fs2 fc0 sc0 ls7 ws3">b) <span class="blank _9"> </span>foi <span class="blank _9"> </span>m<span class="blank _1"> </span>antida <span class="blank _9"> </span>a <span class="blank _9"> </span>recomendação <span class="blank _9"> </span>de <span class="blank _9"> </span>ganho <span class="blank _8"> </span>de <span class="blank _9"> </span>peso <span class="blank _9"> </span>no </div><div class="t m0 x1 h4 yed ff2 fs2 fc0 sc0 ls7 ws3">limite <span class="blank _7"> </span>mínimo <span class="blank _7"> </span>das <span class="blank _7"> </span>faix<span class="blank _0"></span>as <span class="blank _7"> </span>de <span class="blank _7"> </span>ganho <span class="blank _7"> </span>de <span class="blank _2"> </span>peso <span class="blank _7"> </span>gestacional </div><div class="t m0 x1 h4 yee ff2 fs2 fc0 sc0 ls7 ws3">total, <span class="blank _9"> </span>para <span class="blank _9"> </span>as <span class="blank _10"> </span>m<span class="blank _1"> </span>ulheres <span class="blank _10"> </span>com <span class="blank _9"> </span>baixa <span class="blank _10"> </span>esta<span class="blank _1"> </span>tura <span class="blank _10"> </span>(<1,57 <span class="blank _9"> </span>m), </div><div class="t m0 x1 h4 yef ff2 fs2 fc0 sc0 ls7 ws3">segundo as categorias de IMC pré-gestacional </div><div class="t m0 x1 h4 yf0 ff2 fs2 fc0 sc0 ls7 ws3">c) <span class="blank _6"> </span>novos <span class="blank _5"> </span>pontos <span class="blank _6"> </span>de <span class="blank _6"> </span>corte <span class="blank _5"> </span>foram <span class="blank _6"> </span>recomendados <span class="blank _6"> </span>para </div><div class="t m0 x1 h4 yf1 ff2 fs2 fc0 sc0 ls7 ws3">avaliação <span class="blank _7"> </span>do <span class="blank _10"> </span>Índice <span class="blank _7"> </span>de <span class="blank _7"> </span>Massa <span class="blank _7"> </span>Corpo<span class="blank _1"> </span>ral <span class="blank _7"> </span>pré-g<span class="blank _1"> </span>estacional<span class="blank _0"></span> </div><div class="t m0 x1 h4 yf2 ff2 fs2 fc0 sc0 ls7 ws3">e <span class="blank _4"> </span>incorpo<span class="blank _1"> </span>rou-se <span class="blank _4"> </span>os <span class="blank _4"> </span>pontos <span class="blank _a"> </span>de<span class="blank _1"> </span> <span class="blank _4"> </span>corte <span class="blank _4"> </span>propostos <span class="blank _4"> </span>pela </div><div class="t m0 x1 h4 yf3 ff2 fs2 fc0 sc0 ls7 ws3">Organização <span class="blank _e"> </span>Mundial <span class="blank _e"> </span>da <span class="blank _f"> </span>Sa<span class="blank _1"> </span>úde <span class="blank _e"> </span>(1995) <span class="blank _f"> </span>p<span class="blank _1"> </span>ara <span class="blank _f"> </span>tal </div><div class="t m0 x1 h4 yf4 ff2 fs2 fc0 sc0 ls7 ws3">avaliação </div><div class="t m0 x1 h4 yf5 ff2 fs2 fc0 sc0 ls7 ws3">d) <span class="blank _10"> </span>as <span class="blank _9"> </span>gestantes <span class="blank _10"> </span>ad<span class="blank _1"> </span>olescentes<span class="blank _0"></span> <span class="blank _10"> </span>devem <span class="blank _9"> </span>ter <span class="blank _10"> </span>um <span class="blank _9"> </span>ganho <span class="blank _10"> </span>de </div><div class="t m0 x1 h4 yf6 ff2 fs2 fc0 sc0 ls7 ws3">peso <span class="blank _7"> </span>ge<span class="blank _0"></span>stacional <span class="blank _2"> </span>to<span class="blank _1"> </span>tal <span class="blank _2"> </span>maior <span class="blank _2"> </span>qu<span class="blank _1"> </span>e <span class="blank _2"> </span>as <span class="blank _7"> </span>adultas, <span class="blank _2"> </span>segundo <span class="blank _2"> </span>a </div><div class="t m0 x1 h4 yf7 ff2 fs2 fc0 sc0 ls7 ws3">nova recomendação do IOM (2009) </div><div class="t m0 x1 h4 yf8 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 yf9 ff2 fs2 fc0 sc0 ls7 ws3">13) <span class="blank _7"> </span>No <span class="blank _10"> </span>diagnóstico <span class="blank _7"> </span>nu<span class="blank _1"> </span>tricional <span class="blank _7"> </span>de <span class="blank _7"> </span>gesta<span class="blank _1"> </span>ntes, <span class="blank _7"> </span>o <span class="blank _7"> </span>SISVAN </div><div class="t m0 x1 h4 yfa ff2 fs2 fc0 sc0 ls7 ws3">atualmente <span class="blank _7"> </span>preconiza <span class="blank _7"> </span>como <span class="blank _7"> </span>índices <span class="blank _7"> </span>e <span class="blank _7"> </span>parâmetros <span class="blank _7"> </span>(UFF </div><div class="t m0 x1 h4 yfb ff2 fs2 fc0 sc0 ls7 ws3">2009): </div><div class="t m0 x1 h4 yfc ff2 fs2 fc0 sc0 ls7 ws3">(A) <span class="blank"> </span>Índice <span class="blank"> </span>M<span class="blank _0"></span>assa <span class="blank"> </span>Corporal <span class="blank"> </span>p<span class="blank _0"></span>or <span class="blank"> </span>semana <span class="blank _3"> </span>gestacional <span class="blank"> </span>e<span class="blank _0"></span> </div><div class="t m0 x1 h4 yfd ff2 fs2 fc0 sc0 ls7 ws3">ganho de peso por semana gestacional; </div><div class="t m0 x1 h4 yfe ff2 fs2 fc0 sc0 ls7 ws3">(B) Índice Massa <span class="blank _1"> </span>Corporal pré-gestacional e po<span class="blank _1"> </span>r semana </div><div class="t m0 x1 h4 yff ff2 fs2 fc0 sc0 ls7 ws3">gestacional; </div><div class="t m0 x1 h4 y100 ff2 fs2 fc0 sc0 ls7 ws3">(C) <span class="blank _14"> </span>peso <span class="blank _14"> </span>por <span class="blank _12"> </span>e<span class="blank _1"> </span>statura <span class="blank _12"> </span>por <span class="blank _14"> </span>semana <span class="blank _14"> </span>gestacional <span class="blank _14"> </span>e </div><div class="t m0 x1 h4 y101 ff2 fs2 fc0 sc0 ls7 ws3">circuferência de cintura; </div><div class="t m0 x1 h4 y102 ff2 fs2 fc0 sc0 ls7 ws3">(D) <span class="blank _2"> </span>Índice <span class="blank _2"> </span>de <span class="blank _2"> </span>Massa <span class="blank _2"> </span>Corporal <span class="blank _1"> </span>po<span class="blank _1"> </span>r <span class="blank _1"> </span>idade <span class="blank _2"> </span>e <span class="blank _2"> </span>sexo <span class="blank _2"> </span>e <span class="blank _2"> </span>Índice </div><div class="t m0 x1 h4 y103 ff2 fs2 fc0 sc0 ls7 ws3">de Massa Corporal pré-gestacional; </div><div class="t m0 x1 h4 y104 ff2 fs2 fc0 sc0 ls7 ws3">(E) Índice de Massa Corporal e perímetro de quadril. </div><div class="t m0 x1 h4 y105 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y106 ff2 fs2 fc0 sc0 ls7 ws3">14) <span class="blank _c"> </span>A <span class="blank _d"> </span>velocidade <span class="blank _c"> </span>do <span class="blank _d"> </span>aumento <span class="blank _c"> </span>de <span class="blank _d"> </span>peso <span class="blank _c"> </span>durante <span class="blank _c"> </span>a </div><div class="t m0 x1 h4 y107 ff2 fs2 fc0 sc0 ls7 ws3">gravidez <span class="blank _14"> </span>n<span class="blank _1"> </span>o <span class="blank _14"> </span>primeiro <span class="blank _1a"> </span>trimestre <span class="blank _14"> </span>corresponde <span class="blank _1a"> </span>a <span class="blank _14"> </span>um </div><div class="t m0 x1 h4 y108 ff2 fs2 fc0 sc0 ls7 ws3">aumento na faixa de (UERJ): </div><div class="t m0 x1 h4 y109 ff2 fs2 fc0 sc0 ls7 ws3">(A) 350 a 450g </div><div class="t m0 x1 h4 y10a ff2 fs2 fc0 sc0 ls7 ws3">(B) 500 a 600g </div><div class="t m0 x1 h4 y10b ff2 fs2 fc0 sc0 ls7 ws3">(C) 750 a 900g </div><div class="t m0 x1 h4 y10c ff2 fs2 fc0 sc0 ls7 ws3">(D) 900 a 2300g </div><div class="t m0 x1 h4 y10d ff2 fs2 fc0 sc0 ls7 ws3">(E) 2500 a 3500g </div><div class="t m0 x9 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">15) <span class="blank _2"> </span>Segundo <span class="blank _2"> </span>o <span class="blank _1"> </span>Institu<span class="blank _1"> </span>to <span class="blank _1"> </span>de <span class="blank _2"> </span>medicina <span class="blank _2"> </span>(IOM), <span class="blank _1"> </span>reco<span class="blank _1"> </span>menda<span class="blank _1"> </span>-</div><div class="t m0 x9 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3">se <span class="blank _3"> </span>para <span class="blank _8"> </span>gestantes <span class="blank _3"> </span>com <span class="blank _3"> </span>índice <span class="blank _8"> </span>de <span class="blank _3"> </span>massa <span class="blank _3"> </span>corporal <span class="blank _8"> </span>p<span class="blank _1"> </span>ré </div><div class="t m0 x9 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank _7"> </span>entre <span class="blank _7"> </span>19,8 <span class="blank _7"> </span>k<span class="blank _0"></span>g/m<span class="fs7 lsc">2 <span class="blank _7"> </span></span>e <span class="blank _7"> </span>268 <span class="blank _7"> </span>kg/m<span class="fs7 lsc">2 <span class="blank _7"> </span></span>um <span class="blank _7"> </span>ganho <span class="blank _2"> </span>de </div><div class="t m0 x9 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">peso gestacional total de (Emgepron 2010): </div><div class="t m0 x9 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">(A) 7 a 11,5kg </div><div class="t m0 x9 h4 y10e ff2 fs2 fc0 sc0 ls7 ws3">(B) 9 a 12kg </div><div class="t m0 x9 h4 y10f ff2 fs2 fc0 sc0 ls7 ws3">(C) 10,5 a 14kg </div><div class="t m0 x9 h4 y110 ff2 fs2 fc0 sc0 ls7 ws3">(D) 11,5 a 16kg </div><div class="t m0 x9 h4 y111 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y112 ff2 fs2 fc0 sc0 ls7 ws3">16) <span class="blank _3"> </span>Joana, <span class="blank _8"> </span>16 <span class="blank"> </span>a<span class="blank _0"></span>nos, <span class="blank _3"> </span>primigesta, <span class="blank _8"> </span>com <span class="blank"> </span>2<span class="blank _0"></span>8 <span class="blank _8"> </span>s<span class="blank _1"> </span>emanas <span class="blank _8"> </span>de </div><div class="t m0 x9 h4 y113 ff2 fs2 fc0 sc0 ls7 ws3">gestação, <span class="blank _e"> </span>compareceu <span class="blank _e"> </span>à <span class="blank _f"> </span>c<span class="blank _1"> </span>onsulta <span class="blank _e"> </span>de <span class="blank _e"> </span>pré <span class="blank _e"> </span>natal, </div><div class="t m0 x9 h4 y8b ff2 fs2 fc0 sc0 ls7 ws3">relatando <span class="blank _7"> </span>tonteira, <span class="blank _2"> </span>cefaléia, <span class="blank _7"> </span>vômitos <span class="blank _7"> </span>e <span class="blank _2"> </span>e<span class="blank _1"> </span>dema <span class="blank _2"> </span>d<span class="blank _1"> </span>a <span class="blank _2"> </span>face <span class="blank _7"> </span>e </div><div class="t m0 x9 h4 y8c ff2 fs2 fc0 sc0 ls7 ws3">das <span class="blank _d"> </span>mãos, <span class="blank _d"> </span>com <span class="blank _d"> </span>hipótese <span class="blank _4"> </span>de <span class="blank _d"> </span>diagnóstico <span class="blank _d"> </span>clínico <span class="blank _d"> </span>de </div><div class="t m0 x9 h4 y114 ff2 fs2 fc0 sc0 ls7 ws3">distúrbio hipertensivo específico da gestação </div><div class="t m0 x9 h4 y115 ff2 fs2 fc0 sc0 ls7 ws3">Dados antropométricos : </div><div class="t m0 x9 h4 y116 ff2 fs2 fc0 sc0 ls7 ws3">peso pré gestacional : 76kg </div><div class="t m0 x9 h4 y117 ff2 fs2 fc0 sc0 ls7 ws3">Estatura : 1,60m </div><div class="t m0 x9 h4 y118 ff2 fs2 fc0 sc0 ls7 ws3">Peso atual 84kg </div><div class="t m0 x9 h4 y119 ff2 fs2 fc0 sc0 ls7 ws3">Exames laboratoriais : </div><div class="t m0 x9 h4 y11a ff2 fs2 fc0 sc0 ls7 ws3">Hemoglobina : 10,3g/dl Hematócrito : 33% </div><div class="t m0 x9 h4 y11b ff2 fs2 fc0 sc0 ls7 ws3">Albumina: 2,4g/dl Ácido úrico : 3mg/dl </div><div class="t m0 x9 h4 y11c ff2 fs2 fc0 sc0 ls7 ws3">Creatinina : 0,9mg/dl Uréia : 20mg/dl </div><div class="t m0 x9 h4 y11d ff2 fs2 fc0 sc0 ls7 ws3">Proteinúria : 0,35g/24hs TGO : 12U/I </div><div class="t m0 x9 h4 y11e ff2 fs2 fc0 sc0 ls7 ws3">TGP : 8U/I PA : 130 x 90mmHg </div><div class="t m0 x9 h4 yc1 ff2 fs2 fc0 sc0 ls7 ws3">Baseando-se <span class="blank _a"> </span>na <span class="blank _5"> </span>avaliação <span class="blank _a"> </span>do <span class="blank _a"> </span>estado <span class="blank _5"> </span>nutrici<span class="blank _1"> </span>onal <span class="blank _5"> </span>pré </div><div class="t m0 x9 h4 yc2 ff2 fs2 fc0 sc0 ls7 ws3">gestacional, <span class="blank _7"> </span>o <span class="blank _10"> </span>ganho <span class="blank _7"> </span>de<span class="blank _1"> </span> <span class="blank _7"> </span>peso <span class="blank _7"> </span>semanal<span class="blank _1"> </span> <span class="blank _7"> </span>deverá <span class="blank _7"> </span>ser, <span class="blank _10"> </span>em </div><div class="t m0 x9 h4 yc3 ff2 fs2 fc0 sc0 ls7 ws3">kg, de (Residenc<span class="lsd ws8">ia<span class="blank _1"> </span></span>): </div><div class="t m0 x9 h4 yc4 ff2 fs2 fc0 sc0 ls7 ws3">(A) 0,1 </div><div class="t m0 x9 h4 y11f ff2 fs2 fc0 sc0 ls7 ws3">(B) 0,3 </div><div class="t m0 x9 h4 y120 ff2 fs2 fc0 sc0 ls7 ws3">(C) 0,4 </div><div class="t m0 x9 h4 y121 ff2 fs2 fc0 sc0 ls7 ws3">(D) 0,5 </div><div class="t m0 x9 h4 y122 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y123 ff2 fs2 fc0 sc0 ls7 ws3">17) <span class="blank _c"> </span>A <span class="blank _c"> </span>anemia <span class="blank _c"> </span>é <span class="blank _c"> </span>a <span class="blank _c"> </span>intercorrência <span class="blank _c"> </span>gestac<span class="blank _0"></span>ional <span class="blank _c"> </span>mais </div><div class="t m0 x9 h4 y124 ff2 fs2 fc0 sc0 ls7 ws3">prevalente <span class="blank"> </span>no <span class="blank"> </span>Bra<span class="blank _0"></span>sil. <span class="blank"> </span>Para <span class="blank _3"> </span>a <span class="blank _3"> </span>intervenção <span class="blank"> </span>adequada <span class="blank _3"> </span>é </div><div class="t m0 x9 h4 y125 ff2 fs2 fc0 sc0 ls7 ws3">importante <span class="blank _11"> </span>a <span class="blank _11"> </span>correta <span class="blank _11"> </span>interpretação <span class="blank _f"> </span>de <span class="blank _11"> </span>indicadores </div><div class="t m0 x9 h4 y126 ff2 fs2 fc0 sc0 ls7 ws3">sanguíneos. <span class="blank _1e"> </span>Assinale <span class="blank _1e"> </span>a<span class="blank _0"></span> <span class="blank _1e"> </span>afirmativa <span class="blank _1e"> </span>CORR<span class="blank _0"></span>ETA </div><div class="t m0 x9 h4 y127 ff2 fs2 fc0 sc0 ls7 ws3">(Residência Multiprofissional <span class="ff4 ws7">\u2013</span> UFRJ, 2012)<span class="lsb">: </span> </div><div class="t m0 x9 h4 y128 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y129 ff2 fs2 fc0 sc0 ls7 ws3">a) a <span class="blank _1"> </span>concentração d<span class="blank _1"> </span>e hemoglobina é<span class="blank _1"> </span> um <span class="blank _1"> </span>indicador inicial </div><div class="t m0 x9 h4 y12a ff2 fs2 fc0 sc0 ls7 ws3">da anemia <span class="blank _1"> </span>e a concentração <span class="blank _1"> </span>de hemoglobina menor que </div><div class="t m0 x9 h4 y12b ff2 fs2 fc0 sc0 ls7 ws3">10g/dl sugere o diagnóstico de anemia gestacional </div><div class="t m0 x9 h4 y12c ff2 fs2 fc0 sc0 ls7 ws3">b) <span class="blank"> </span>o <span class="blank _6"> </span>Volume <span class="blank _6"> </span>Corpuscular <span class="blank"> </span>Médio <span class="blank _6"> </span>(VCM) <span class="blank"> </span>representa <span class="blank"> </span>o </div><div class="t m0 x9 h4 y12d ff2 fs2 fc0 sc0 ls7 ws3">volume <span class="blank _3"> </span>médio <span class="blank _8"> </span>dos <span class="blank _8"> </span>eri<span class="blank _1"> </span>trócitos <span class="blank _9"> </span>e<span class="blank _1"> </span> <span class="blank _8"> </span>se <span class="blank _3"> </span>houver <span class="blank _8"> </span>microcitose </div><div class="t m0 x9 h4 y12e ff2 fs2 fc0 sc0 ls7 ws3">(eritrócito <span class="blank _7"> </span>< <span class="blank _10"> </span>que <span class="blank _7"> </span>percentil <span class="blank _7"> </span>5 <span class="blank _10"> </span>para <span class="blank _7"> </span>a <span class="blank _7"> </span>i<span class="blank _1"> </span>dade <span class="blank _7"> </span>da <span class="blank _7"> </span>população </div><div class="t m0 x9 h4 y12f ff2 fs2 fc0 sc0 ls7 ws3">de referência) é sinal de anemia megaloblástica </div><div class="t m0 x9 h4 y130 ff2 fs2 fc0 sc0 ls7 ws3">c) <span class="blank"> </span>a <span class="blank _8"> </span>ferritina <span class="blank"> </span>é <span class="blank _8"> </span>um<span class="blank _1"> </span>a <span class="blank _3"> </span>proteína <span class="blank _8"> </span>de <span class="blank"> </span>fase <span class="blank _3"> </span>aguda, <span class="blank"> </span>mas <span class="blank _8"> </span>s<span class="blank _1"> </span>e </div><div class="t m0 x9 h4 y131 ff2 fs2 fc0 sc0 ls7 ws3">mantém <span class="blank _f"> </span>inalte<span class="blank _1"> </span>rada <span class="blank _f"> </span>nos <span class="blank _f"> </span>processos <span class="blank _f"> </span>i<span class="blank _1"> </span>nfecciosos <span class="blank _f"> </span>ou </div><div class="t m0 x9 h4 y132 ff2 fs2 fc0 sc0 ls7 ws3">inflamatórios </div><div class="t m0 x9 h4 y133 ff2 fs2 fc0 sc0 ls7 ws3">d) <span class="blank _10"> </span>segundo <span class="blank _10"> </span>a <span class="blank _10"> </span>avaliação <span class="blank _7"> </span>d<span class="blank _1"> </span>o <span class="blank _7"> </span>VCM, <span class="blank _10"> </span>a <span class="blank _10"> </span>microcitose <span class="blank _10"> </span>é <span class="blank _10"> </span>sinal </div><div class="t m0 x9 h4 y134 ff2 fs2 fc0 sc0 ls7 ws3">de anemia ferropriva </div><div class="t m0 x9 h4 y135 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y136 ff2 fs2 fc0 sc0 ls7 ws3">18) <span class="blank _c"> </span>Náuseas <span class="blank _d"> </span>e<span class="blank _1"> </span> <span class="blank _d"> </span>vômi<span class="blank _1"> </span>tos <span class="blank _d"> </span>são <span class="blank _c"> </span>comuns <span class="blank _c"> </span>ao <span class="blank _d"> </span>início <span class="blank _c"> </span>da </div><div class="t m0 x9 h4 y137 ff2 fs2 fc0 sc0 ls7 ws3">gravidez, <span class="blank _5"> </span>desta <span class="blank _a"> </span>forma <span class="blank _5"> </span>o <span class="blank _5"> </span>nu<span class="blank _1"> </span>tricionista <span class="blank _5"> </span>deverá <span class="blank _5"> </span>orientar </div><div class="t m0 x9 h4 y138 ff2 fs2 fc0 sc0 ls7 ws3">estas gestantes para que as refeições sejam (UERJ): </div><div class="t m0 x9 h4 y79 ff2 fs2 fc0 sc0 ls7 ws3">(A) Frequentes, regularmente secas, ricas em proteínas </div><div class="t m0 x9 h4 y3b ff2 fs2 fc0 sc0 ls7 ws3">(B) <span class="blank _2"> </span>Freque<span class="blank _1"> </span>ntes, <span class="blank _2"> </span>à <span class="blank _2"> </span>b<span class="blank _1"> </span>ase <span class="blank _2"> </span>de <span class="blank _2"> </span>l<span class="blank _1"> </span>íquido, <span class="blank _2"> </span>ricas <span class="blank _2"> </span>em <span class="blank _7"> </span>hidratos <span class="blank _1"> </span>de </div><div class="t m0 x9 h4 y3c ff2 fs2 fc0 sc0 ls7 ws3">carbono </div><div class="t m0 x9 h4 y139 ff2 fs2 fc0 sc0 ls7 ws3">(C) <span class="blank _10"> </span>Com<span class="blank _1"> </span> <span class="blank _10"> </span>intervalos <span class="blank _9"> </span>maiores, <span class="blank _7"> </span>re<span class="blank _1"> </span>gularmente <span class="blank _10"> </span>secas, <span class="blank _9"> </span>ricas </div><div class="t m0 x9 h4 y13a ff2 fs2 fc0 sc0 ls7 ws3">em lipídios </div><div class="t m0 x9 h4 y13b ff2 fs2 fc0 sc0 ls7 ws3">(D) <span class="blank _10"> </span>Frequentes, <span class="blank _9"> </span>regularmente <span class="blank _10"> </span>secas, <span class="blank _10"> </span>ricas <span class="blank _10"> </span>e<span class="blank _1"> </span>m <span class="blank _7"> </span>h<span class="blank _1"> </span>idratos </div><div class="t m0 x9 h4 y13c ff2 fs2 fc0 sc0 ls7 ws3">de carbono </div><div class="t m0 x9 h4 y13d ff2 fs2 fc0 sc0 ls7 ws3">(E) Com intervalos m<span class="blank _1"> </span>aiores, à base de líquidos, ricas em </div><div class="t m0 x9 h4 y13e ff2 fs2 fc0 sc0 ls7 ws3">proteínas </div><div class="t m0 x9 h4 y13f ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y140 ff2 fs2 fc0 sc0 ls7 ws3">19) <span class="blank _8"> </span>Para<span class="blank _1"> </span> <span class="blank _8"> </span>as <span class="blank _8"> </span>g<span class="blank _1"> </span>estantes <span class="blank _8"> </span>que <span class="blank _8"> </span>apresentam <span class="blank _3"> </span>pirose, <span class="blank _8"> </span>não <span class="blank _8"> </span>é </div><div class="t m0 x9 h4 y141 ff2 fs2 fc0 sc0 ls7 ws3">recomendado (IABAS 2010): </div><div class="t m0 x9 h4 y142 ff2 fs2 fc0 sc0 ls7 ws3">(A) Evitar café, chá, mate, álcool, doces e frituras </div><div class="t m0 x9 h4 y143 ff2 fs2 fc0 sc0 ls7 ws3">(B) <span class="blank _7"> </span>Substituir <span class="blank _7"> </span>os<span class="blank _1"> </span> <span class="blank _7"> </span>alimentos <span class="blank _7"> </span>que <span class="blank _7"> </span>causem <span class="blank _7"> </span>desconforto <span class="blank _7"> </span>ou </div><div class="t m0 x9 h4 y144 ff2 fs2 fc0 sc0 ls7 ws3">intolerância </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1 ye5 w7 he" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg4.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">289 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">(C) <span class="blank _7"> </span>Incluir <span class="blank _7"> </span>o <span class="blank _7"> </span>leite <span class="blank _7"> </span>na <span class="blank _10"> </span>dieta, <span class="blank _7"> </span>evitando <span class="blank _7"> </span>sua <span class="blank _7"> </span>utilização <span class="blank _7"> </span>para </div><div class="t m0 x1 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">tamponamento gástrico </div><div class="t m0 x1 h4 y145 ff2 fs2 fc0 sc0 ls7 ws3">(D) <span class="blank _7"> </span>Elevar <span class="blank _7"> </span>a <span class="blank _2"> </span>cabeceira <span class="blank _7"> </span>da <span class="blank _7"> </span>ca<span class="blank _0"></span>ma <span class="blank _7"> </span>e <span class="blank _7"> </span>ev<span class="blank _0"></span>itar <span class="blank _7"> </span>deitar-s<span class="blank _1"> </span>e <span class="blank _2"> </span>após </div><div class="t m0 x1 h4 y146 ff2 fs2 fc0 sc0 ls7 ws3">as grandes refeições </div><div class="t m0 x1 h4 y147 ff2 fs2 fc0 sc0 ls7 ws3">(E) <span class="blank _7"> </span>Fazer <span class="blank _7"> </span>dieta <span class="blank _7"> </span>menos <span class="blank _7"> </span>fracionada, <span class="blank _7"> </span>evitando <span class="blank _7"> </span>a <span class="blank _7"> </span>hipotonia </div><div class="t m0 x1 h4 y148 ff2 fs2 fc0 sc0 ls7 ws3">do <span class="blank _2"> </span>es<span class="blank _1"> </span>fíncter <span class="blank _2"> </span>esofagiano <span class="blank _2"> </span>in<span class="blank _1"> </span>ferior, <span class="blank _1"> </span>ac<span class="blank _1"> </span>arretando <span class="blank _2"> </span>o <span class="blank _2"> </span>refl<span class="blank _1"> </span>uxo <span class="blank _1"> </span>e </div><div class="t m0 x1 h4 y149 ff2 fs2 fc0 sc0 ls7 ws3">a pirose </div><div class="t m0 x1 h4 y10f ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y14a ff2 fs2 fc0 sc0 ls7 ws3">20) <span class="blank _7"> </span>Marque <span class="blank _7"> </span>a <span class="blank _7"> </span>alternativa <span class="blank _7"> </span>que <span class="blank _7"> </span>representa <span class="blank _7"> </span>uma <span class="blank _7"> </span>condição </div><div class="t m0 x1 h4 y14b ff2 fs2 fc0 sc0 ls7 ws3">comum <span class="blank"> </span>em<span class="blank _0"></span> <span class="blank"> </span>casos <span class="blank _8"> </span>de <span class="blank"> </span>gestação <span class="blank _3"> </span>gemelar <span class="blank _3"> </span>ou <span class="blank _3"> </span>no <span class="blank _3"> </span>último </div><div class="t m0 x1 h4 y14c ff2 fs2 fc0 sc0 ls7 ws3">trimestre <span class="blank _6"> </span>d<span class="blank _1"> </span>e <span class="blank _6"> </span>gestação <span class="blank _5"> </span>devido <span class="blank _5"> </span>à <span class="blank _5"> </span>compressão <span class="blank _5"> </span>gástrica </div><div class="t m0 x1 h4 y8a ff2 fs2 fc0 sc0 ls7 ws3">pelo útero aumentado (UNIRIO 2011). </div><div class="t m0 x1 h4 y14d ff2 fs2 fc0 sc0 ls7 ws3">(A) Sensação de plenitude. </div><div class="t m0 x1 h4 y8c ff2 fs2 fc0 sc0 ls7 ws3">(B) Picamalácia. </div><div class="t m0 x1 h4 y8d ff2 fs2 fc0 sc0 ls7 ws3">(C) Eructação. </div><div class="t m0 x1 h4 y14e ff2 fs2 fc0 sc0 ls7 ws3">(D) Náuseas e refluxo. </div><div class="t m0 x1 h4 y14f ff2 fs2 fc0 sc0 ls7 ws3">(E) Ptialismo. </div><div class="t m0 x1 h4 y90 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y150 ff2 fs2 fc0 sc0 ls7 ws3">21) <span class="blank _14"> </span>Durante <span class="blank _14"> </span>a <span class="blank _1a"> </span>gestação, <span class="blank _12"> </span>os <span class="blank _14"> </span>cuidados <span class="blank _1a"> </span>nutri<span class="blank _0"></span>cionais </div><div class="t m0 x1 h4 y151 ff2 fs2 fc0 sc0 ls7 ws3">correlacionam-se <span class="blank _10"> </span>com <span class="blank _10"> </span>cada <span class="blank _10"> </span>período <span class="blank _10"> </span>gestacional <span class="blank _10"> </span>e <span class="blank _10"> </span>com </div><div class="t m0 x1 h4 y152 ff2 fs2 fc0 sc0 ls7 ws3">as <span class="blank _1a"> </span>principais <span class="blank _11"> </span>queixas <span class="blank _1a"> </span>das <span class="blank _1a"> </span>gestantes. <span class="blank _11"> </span>Sobre <span class="blank _1a"> </span>isso, </div><div class="t m0 x1 h4 y153 ff2 fs2 fc0 sc0 ls7 ws3">assinale a alternativa correta (UFPR): </div><div class="t m0 x1 h4 y154 ff2 fs2 fc0 sc0 ls7 ws3">(A) <span class="blank _3"> </span>Durante <span class="blank _8"> </span>os <span class="blank"> </span>episódios <span class="blank _8"> </span>de <span class="blank _3"> </span>vômitos <span class="blank _3"> </span>mais <span class="blank _8"> </span>frequentes </div><div class="t m0 x1 h4 y155 ff2 fs2 fc0 sc0 ls7 ws3">deve-se <span class="blank _a"> </span>fracionar <span class="blank _4"> </span>a <span class="blank _a"> </span>alimentação <span class="blank _a"> </span>e <span class="blank _a"> </span>fornecer <span class="blank _a"> </span>grandes </div><div class="t m0 x1 h4 y156 ff2 fs2 fc0 sc0 ls7 ws3">volumes de líquidos. </div><div class="t m0 x1 h4 y157 ff2 fs2 fc0 sc0 ls7 ws3">(B) <span class="blank _d"> </span>A <span class="blank _c"> </span>azia <span class="blank _d"> </span>pode <span class="blank _c"> </span>ser <span class="blank _d"> </span>provocada <span class="blank _d"> </span>pel<span class="blank _1"> </span>o <span class="blank _d"> </span>consumo <span class="blank _d"> </span>d<span class="blank _1"> </span>e </div><div class="t m0 x1 h4 y158 ff2 fs2 fc0 sc0 ls7 ws3">alimentos <span class="blank _17"> </span>condimentados, <span class="blank _13"> </span>frituras<span class="blank _1"> </span> <span class="blank _17"> </span>e <span class="blank _13"> </span>excesso <span class="blank _17"> </span>de<span class="blank _0"></span> </div><div class="t m0 x1 h4 y159 ff2 fs2 fc0 sc0 ls7 ws3">gorduras, evitando-se refeições volumosas. </div><div class="t m0 x1 h4 y15a ff2 fs2 fc0 sc0 ls7 ws3">(C) <span class="blank _4"> </span>A <span class="blank _d"> </span>constipação <span class="blank _4"> </span>in<span class="blank _1"> </span>testinal <span class="blank _4"> </span>pode <span class="blank _d"> </span>ser <span class="blank _4"> </span>aliviada <span class="blank _4"> </span>pelo </div><div class="t m0 x1 h4 y15b ff2 fs2 fc0 sc0 ls7 ws3">consumo <span class="blank _6"> </span>de <span class="blank _6"> </span>fibras, <span class="blank"> </span>vegetais <span class="blank _6"> </span>folhosos <span class="blank"> </span>e<span class="blank _1"> </span> <span class="blank"> </span>frutas <span class="blank"> </span>c<span class="blank _1"> </span>omo: </div><div class="t m0 x1 h4 y15c ff2 fs2 fc0 sc0 ls7 ws3">laranja, abacaxi, mamão, caju e goiaba. </div><div class="t m0 x1 h4 y121 ff2 fs2 fc0 sc0 ls7 ws3">(D) <span class="blank _1"> </span>Durante<span class="blank _1"> </span> <span class="blank _1"> </span>a <span class="blank _1"> </span>g<span class="blank _1"> </span>ravidez, <span class="blank _1"> </span>o <span class="blank _1"> </span>ganho <span class="blank _1"> </span>de<span class="blank _1"> </span> <span class="blank _1"> </span>peso <span class="blank _1"> </span>deve <span class="blank _2"> </span>se <span class="blank _1"> </span>si<span class="blank _1"> </span>tua<span class="blank _1"> </span><span class="lse">r </span></div><div class="t m0 x1 h4 y122 ff2 fs2 fc0 sc0 ls7 ws3">no <span class="blank _2"> </span>máximo <span class="blank _2"> </span>em <span class="blank _7"> </span>7 <span class="blank _2"> </span>Kg, <span class="blank _2"> </span>no <span class="blank _2"> </span>total <span class="blank _2"> </span>da <span class="blank _7"> </span>gestação, <span class="blank _1"> </span>exigindo <span class="blank _2"> </span>um </div><div class="t m0 x1 h4 y123 ff2 fs2 fc0 sc0 ls7 ws3">acompanhamento <span class="blank _9"> </span>de <span class="blank _8"> </span>dieta <span class="blank _8"> </span>hipocalórica <span class="blank _9"> </span>p<span class="blank _1"> </span>ara <span class="blank _9"> </span>perda <span class="blank _9"> </span>d<span class="blank _1"> </span>e </div><div class="t m0 x1 h4 y124 ff2 fs2 fc0 sc0 ls7 ws3">peso nas gestantes com sobrepeso. </div><div class="t m0 x1 h4 y125 ff2 fs2 fc0 sc0 ls7 ws3">(E) <span class="blank _4"> </span>O <span class="blank _d"> </span>álcool <span class="blank _4"> </span>e<span class="blank _1"> </span> <span class="blank _4"> </span>o <span class="blank _4"> </span>café <span class="blank _d"> </span>devem <span class="blank _4"> </span>ser <span class="blank _d"> </span>estimulados <span class="blank _4"> </span>em </div><div class="t m0 x1 h4 y126 ff2 fs2 fc0 sc0 ls3 ws3">quantidades <span class="blank _0"></span>pequena<span class="blank _0"></span>s. </div><div class="t m0 x1 h4 y127 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y128 ff2 fs2 fc0 sc0 ls7 ws3">22) <span class="blank _7"> </span>Arminda, <span class="blank _7"> </span>30 <span class="blank _7"> </span>anos, <span class="blank _7"> </span>tabagista, <span class="blank _7"> </span>realizou <span class="blank _7"> </span>gas<span class="blank _1"> </span>troplastia. </div><div class="t m0 x1 h4 y129 ff2 fs2 fc0 sc0 ls7 ws3">Dois <span class="blank _7"> </span>a<span class="blank _1"> </span>nos <span class="blank _7"> </span>subsequentes <span class="blank _10"> </span>a <span class="blank _10"> </span>esta <span class="blank _7"> </span>ci<span class="blank _1"> </span>rurgia, <span class="blank _7"> </span>mantendo <span class="blank _10"> </span>um </div><div class="t m0 x1 h4 y12a ff2 fs2 fc0 sc0 ls7 ws3">IMC <span class="blank _7"> </span>de <span class="blank _2"> </span>2<span class="blank _1"> </span>8 <span class="blank _7"> </span>kg/m2, <span class="blank _7"> </span>engravidou. <span class="blank _2"> </span> <span class="blank _7"> </span>No <span class="blank _7"> </span>ambulatório <span class="blank _7"> </span>de <span class="blank _7"> </span>pré<span class="blank _1"> </span>-</div><div class="t m0 x1 h4 y12b ff2 fs2 fc0 sc0 ls7 ws3">natal, <span class="blank _8"> </span>estando <span class="blank _8"> </span>na <span class="blank _8"> </span>8ª <span class="blank _3"> </span>semana <span class="blank _9"> </span>de <span class="blank _8"> </span>ges<span class="blank _1"> </span>tação, <span class="blank _9"> </span>relatou <span class="blank _3"> </span>ao </div><div class="t m0 x1 h4 y12c ff2 fs2 fc0 sc0 ls7 ws3">nutricionista <span class="blank _7"> </span>fazer <span class="blank _7"> </span>refeições <span class="blank _7"> </span>regulares <span class="blank _7"> </span>e, <span class="blank _7"> </span>nos <span class="blank _7"> </span>intervalos, </div><div class="t m0 x1 h4 y12d ff2 fs2 fc0 sc0 ls7 ws3">tomar milkshakes. </div><div class="t m0 x1 h4 y12e ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _2"> </span>o<span class="blank _1"> </span>rientação <span class="blank _7"> </span>quanto <span class="blank _2"> </span>à <span class="blank _7"> </span>suplementação <span class="blank _2"> </span>de <span class="blank _7"> </span>vitaminas <span class="blank _2"> </span>e <span class="blank _7"> </span>o </div><div class="t m0 x1 h4 y12f ff2 fs2 fc0 sc0 ls7 ws3">ganho <span class="blank _1f"> </span>de <span class="blank _1f"> </span>peso <span class="blank _1f"> </span>máximo <span class="blank _1f"> </span>para <span class="blank _1f"> </span>Arminda <span class="blank _1f"> </span>são, </div><div class="t m0 x1 h4 y130 ff2 fs2 fc0 sc0 ls7 ws3">respectivamente (HUPE, 2011): </div><div class="t m0 x1 h4 y131 ff2 fs2 fc0 sc0 ls1 ws9">a)<span class="ls7 ws3"> <span class="blank _4"> </span>Folato e B6; 12,5kg </span></div><div class="t m0 x1 h4 y132 ff2 fs2 fc0 sc0 ls1 ws9">b)<span class="ls7 ws3"> <span class="blank _4"> </span>Niacina e B1; 6kg </span></div><div class="t m0 x1 h4 y133 ff2 fs2 fc0 sc0 lsf wsa">c)<span class="ls7 ws3"> <span class="blank _d"> </span>Riboflavina e biotina, 15,0kg </span></div><div class="t m0 x1 h4 y134 ff2 fs2 fc0 sc0 ls1 ws9">d)<span class="ls7 ws3"> <span class="blank _4"> </span>Ácido ascórbico e B12, 11,5kg </span></div><div class="t m0 x1 h4 y135 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y136 ff2 fs2 fc0 sc0 ls7 ws3">23) <span class="blank _2"> </span>O <span class="blank _2"> </span>custo <span class="blank _2"> </span>energético <span class="blank _2"> </span>para <span class="blank _2"> </span>o <span class="blank _2"> </span>desenvolvimento<span class="blank _1"> </span> <span class="blank _2"> </span>de <span class="blank _2"> </span>uma </div><div class="t m0 x1 h4 y137 ff2 fs2 fc0 sc0 ls7 ws3">gestação <span class="blank _1b"> </span>normal, <span class="blank _1c"> </span>adotado <span class="blank _1c"> </span>pelo <span class="blank _1b"> </span>comitê <span class="blank _1c"> </span>da </div><div class="t m0 x1 h4 y138 ff2 fs2 fc0 sc0 ls7 ws3">FAO/WHO/ONU <span class="blank _a"> </span>desde <span class="blank _4"> </span>2004 <span class="blank _5"> </span>é <span class="blank _a"> </span>d<span class="blank _1"> </span>e <span class="blank _a"> </span>aproximadamente </div><div class="t m0 x1 h4 y79 ff2 fs2 fc0 sc0 ls7 ws3">(UFRJ 2011): </div><div class="t m0 x1 h4 y15d ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y15e ff2 fs2 fc0 sc0 ls7 ws3">(A) <span class="blank _a"> </span>85.0<span class="blank _1"> </span>00kcal, <span class="blank _a"> </span>associado <span class="blank _a"> </span>com <span class="blank _4"> </span>adequado <span class="blank _a"> </span>ganho <span class="blank _4"> </span>de </div><div class="t m0 x1 h4 y15f ff2 fs2 fc0 sc0 ls7 ws3">peso <span class="blank _9"> </span>gestacional <span class="blank _9"> </span>total, <span class="blank _9"> </span>variando <span class="blank _10"> </span>entre <span class="blank _9"> </span>10 <span class="blank _9"> </span>a <span class="blank _9"> </span>14kg, <span class="blank _9"> </span>com </div><div class="t m0 x1 h4 y160 ff2 fs2 fc0 sc0 ls7 ws3">média de 12kg e com maior chance de recém-nasci<span class="ls10 wsb">do</span> </div><div class="t m0 x1 h4 y161 ff2 fs2 fc0 sc0 ls7 ws3">com <span class="blank _2"> </span>peso <span class="blank _2"> </span>de <span class="blank _2"> </span>3,3kg <span class="blank _2"> </span>e <span class="blank _2"> </span>menores <span class="blank _2"> </span>índices <span class="blank _2"> </span>de <span class="blank _2"> </span>complicações </div><div class="t m0 x1 h4 y40 ff2 fs2 fc0 sc0 ls7 ws3">materno-fetais </div><div class="t m0 x1 h4 y162 ff2 fs2 fc0 sc0 ls7 ws3">(B) <span class="blank _a"> </span>67.0<span class="blank _1"> </span>00kcal, <span class="blank _a"> </span>associado <span class="blank _a"> </span>com <span class="blank _4"> </span>adequado <span class="blank _a"> </span>ganho <span class="blank _4"> </span>de </div><div class="t m0 x1 h4 y163 ff2 fs2 fc0 sc0 ls7 ws3">peso <span class="blank _9"> </span>gestacional <span class="blank _9"> </span>total, <span class="blank _9"> </span>variando <span class="blank _10"> </span>entre <span class="blank _9"> </span>10 <span class="blank _9"> </span>a <span class="blank _9"> </span>14kg, <span class="blank _9"> </span>com </div><div class="t m0 x1 h4 y164 ff2 fs2 fc0 sc0 ls7 ws3">média <span class="blank _7"> </span>de <span class="blank _10"> </span>12kg <span class="blank _10"> </span>e <span class="blank _7"> </span>com <span class="blank _10"> </span>maior <span class="blank _7"> </span>chance <span class="blank _10"> </span>de <span class="blank _10"> </span>recém<span class="blank _1"> </span>-nascido </div><div class="t m0 x1 h4 y165 ff2 fs2 fc0 sc0 ls7 ws3">com <span class="blank _2"> </span>peso <span class="blank _2"> </span>de <span class="blank _2"> </span>3,3kg <span class="blank _2"> </span>e <span class="blank _2"> </span>menores <span class="blank _2"> </span>índic<span class="blank _1"> </span>es <span class="blank _2"> </span>de <span class="blank _1"> </span>c<span class="blank _1"> </span>omplicações </div><div class="t m0 x1 h4 y166 ff2 fs2 fc0 sc0 ls7 ws3">materno-fetais </div><div class="t m0 x1 h4 y142 ff2 fs2 fc0 sc0 ls7 ws3">(C) <span class="blank _a"> </span>77.000kcal, <span class="blank _a"> </span>a<span class="blank _1"> </span>ssociado <span class="blank _5"> </span>com <span class="blank _4"> </span>adequado <span class="blank _a"> </span>ganho <span class="blank _a"> </span>de </div><div class="t m0 x1 h4 y167 ff2 fs2 fc0 sc0 ls7 ws3">peso <span class="blank"> </span>gesta<span class="blank _0"></span>cional <span class="blank"> </span>total, <span class="blank _8"> </span>variando <span class="blank"> </span>entre <span class="blank _8"> </span>7 <span class="blank"> </span>a <span class="blank _3"> </span>12kg, <span class="blank _3"> </span>com </div><div class="t m0 x1 h4 y168 ff2 fs2 fc0 sc0 ls7 ws3">média <span class="blank _7"> </span>de <span class="blank _10"> </span>10kg <span class="blank _10"> </span>e <span class="blank _7"> </span>com <span class="blank _10"> </span>maior <span class="blank _7"> </span>chance <span class="blank _10"> </span>de <span class="blank _10"> </span>recém<span class="blank _1"> </span>-nascido </div><div class="t m0 x9 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">com <span class="blank _2"> </span>peso <span class="blank _2"> </span>de <span class="blank _2"> </span>2,5kg <span class="blank _2"> </span>e <span class="blank _2"> </span>menores <span class="blank _2"> </span>índices <span class="blank _2"> </span>de <span class="blank _2"> </span>complicações </div><div class="t m0 x9 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">materno-fetais </div><div class="t m0 x9 h4 y48 ff2 fs2 fc0 sc0 ls11 wsc">(D<span class="ls7 ws3">) <span class="blank _a"> </span>77.000kcal, <span class="blank _a"> </span>associa<span class="blank _1"> </span>do <span class="blank _5"> </span>com <span class="blank _4"> </span>adequado <span class="blank _a"> </span>ganho <span class="blank _a"> </span>de </span></div><div class="t m0 x9 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">peso <span class="blank _9"> </span>gestacional <span class="blank _9"> </span>total, <span class="blank _9"> </span>variando <span class="blank _10"> </span>entre <span class="blank _9"> </span>10 <span class="blank _9"> </span>a <span class="blank _9"> </span>14kg, <span class="blank _9"> </span>com </div><div class="t m0 x9 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">média <span class="blank _7"> </span>de <span class="blank _10"> </span>12kg <span class="blank _10"> </span>e <span class="blank _7"> </span>com <span class="blank _10"> </span>maior <span class="blank _7"> </span>chance <span class="blank _10"> </span>de <span class="blank _10"> </span>recém<span class="blank _1"> </span>-nascido </div><div class="t m0 x9 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">com <span class="blank _2"> </span>peso <span class="blank _2"> </span>de <span class="blank _2"> </span>3,3kg <span class="blank _2"> </span>e <span class="blank _2"> </span>menores <span class="blank _2"> </span>índices <span class="blank _2"> </span>de <span class="blank _2"> </span>complicações </div><div class="t m0 x9 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">materno-fetais </div><div class="t m0 x9 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">24) <span class="blank _a"> </span>A <span class="blank _a"> </span>ingestão <span class="blank _a"> </span>calórica <span class="blank _a"> </span>adicional <span class="blank _a"> </span>rec<span class="blank _1"> </span>omendada <span class="blank _5"> </span>pela </div><div class="t m0 x9 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">RDA/89 na gravidez é<span class="ls12">: </span> </div><div class="t m0 x9 h4 y169 ff2 fs2 fc0 sc0 ls7 ws3">(A) 300kcal nos 3 trimestres </div><div class="t m0 x9 h4 y16a ff2 fs2 fc0 sc0 ls7 ws3">(B) 300kcal apenas no 2 e 3º trimestres </div><div class="t m0 x9 h4 y14d ff2 fs2 fc0 sc0 ls7 ws3">(C) 300kcal apenas no último trimestre </div><div class="t m0 x9 h4 y16b ff2 fs2 fc0 sc0 ls7 ws3">(D) 500kcal no último trimestre </div><div class="t m0 x9 h4 y16c ff2 fs2 fc0 sc0 ls7 ws3">(E) 500kcal no 2 e 3º trimestres </div><div class="t m0 x9 h4 y14e ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y16d ff2 fs2 fc0 sc0 ls7 ws3">25) <span class="blank _6"> </span>Segu<span class="blank _1"> </span>ndo <span class="blank _6"> </span>a <span class="blank _6"> </span>FAO/OMS, <span class="blank _5"> </span>2004, <span class="blank _5"> </span>o <span class="blank _6"> </span>cálculo <span class="blank _5"> </span>d<span class="blank _1"> </span>o <span class="blank _6"> </span>valor </div><div class="t m0 x9 h4 y16e ff2 fs2 fc0 sc0 ls7 ws3">energético <span class="blank _2"> </span>total <span class="blank _7"> </span>da <span class="blank _2"> </span>gestante <span class="blank _2"> </span>inclui <span class="blank _2"> </span>o <span class="blank _7"> </span>somatório <span class="blank _1"> </span>do <span class="blank _7"> </span>gasto </div><div class="t m0 x9 h4 y16f ff2 fs2 fc0 sc0 ls7 ws3">energético <span class="blank _9"> </span>com <span class="blank _8"> </span>o <span class="blank _9"> </span>adicional <span class="blank _8"> </span>energético <span class="blank _9"> </span>gestacional. <span class="blank _8"> </span>No </div><div class="t m0 x9 h4 y170 ff2 fs2 fc0 sc0 ls7 ws3">1º, <span class="blank"> </span>no <span class="blank"> </span>2º<span class="blank _0"></span> <span class="blank"> </span>e <span class="blank"> </span>no<span class="blank _0"></span> <span class="blank"> </span>3º <span class="blank"> </span>tr<span class="blank _0"></span>imestres <span class="blank"> </span>gestacionais, <span class="blank _3"> </span>os <span class="blank"> </span>va<span class="blank _0"></span>lores </div><div class="t m0 x9 h4 y171 ff2 fs2 fc0 sc0 ls7 ws3">desse <span class="blank _13"> </span>adicional <span class="blank _e"> </span>devem <span class="blank _e"> </span>ser, <span class="blank _13"> </span>respectivamente, <span class="blank _13"> </span>de<span class="blank _0"></span> </div><div class="t m0 x9 h4 y172 ff2 fs2 fc0 sc0 ls7 ws3">(FIOCRUZ 2010): </div><div class="t m0 x9 h4 y173 ff2 fs2 fc0 sc0 ls7 ws3">(A) 85 kcal/dia, 285 kcal/dia e 475 kcal/dia. </div><div class="t m0 x9 h4 y155 ff2 fs2 fc0 sc0 ls7 ws3">(B) 185 kcal/dia, 285 kcal/dia e 500 kcal/dia. </div><div class="t m0 x9 h4 y174 ff2 fs2 fc0 sc0 ls7 ws3">(C) 200 kcal/dia, 285 kcal/dia e 500 kcal/dia. </div><div class="t m0 x9 h4 y175 ff2 fs2 fc0 sc0 ls7 ws3">(D) 285 kcal/dia, 385 kcal/dia e 475 kcal/dia. </div><div class="t m0 x9 h4 y176 ff2 fs2 fc0 sc0 ls7 ws3">(E) 285 kcal/dia, 485 kcal/dia e 675 kcal/dia. </div><div class="t m0 x9 h4 y177 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y178 ff2 fs2 fc0 sc0 ls7 ws3">26) <span class="blank _20"> </span>Com <span class="blank _20"> </span>base <span class="blank _20"> </span>nas <span class="blank _20"> </span>recomendações <span class="blank _20"> </span>da </div><div class="t m0 x9 h4 y179 ff2 fs2 fc0 sc0 ls7 ws3">FAO/Organização <span class="blank _4"> </span>Mundial <span class="blank _4"> </span>de <span class="blank _4"> </span>Saúde<span class="blank _1"> </span>-1985, <span class="blank _4"> </span>para <span class="blank _4"> </span>um </div><div class="t m0 x9 h4 y17a ff2 fs2 fc0 sc0 ls7 ws3">ganho <span class="blank _7"> </span>pondera<span class="blank _0"></span>l <span class="blank _7"> </span>gestacional <span class="blank _2"> </span>de <span class="blank _2"> </span>12,5<span class="blank _1"> </span>Kg <span class="blank _2"> </span>são <span class="blank _7"> </span>necessários<span class="blank _0"></span> </div><div class="t m0 x9 h4 y17b ff2 fs2 fc0 sc0 ls7 ws3">80000Kcal, <span class="blank _c"> </span>logo <span class="blank _c"> </span>para <span class="blank _d"> </span>cad<span class="blank _1"> </span>a <span class="blank _d"> </span>1<span class="blank _1"> </span> <span class="blank _c"> </span>Kg <span class="blank _c"> </span>é <span class="blank _d"> </span>requerido <span class="blank _c"> </span>um </div><div class="t m0 x9 h4 y17c ff2 fs2 fc0 sc0 ls7 ws3">adicional energético de: (Eletronorte<span class="lse">) </span> </div><div class="t m0 x9 h4 y17d ff2 fs2 fc0 sc0 ls7 ws3">(A) 4000Kcal (D) 7400Kcal </div><div class="t m0 x9 h4 y17e ff2 fs2 fc0 sc0 ls7 ws3">(B) 5700Kcal (E) 8200KcaL </div><div class="t m0 x9 h4 y17f ff2 fs2 fc0 sc0 ls7 ws3">(C) 6400Kcal </div><div class="t m0 x9 h4 y180 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y181 ff2 fs2 fc0 sc0 ls1">27<span class="ls7 ws3">) <span class="blank _7"> </span>Vitolo <span class="blank _10"> </span>refere <span class="blank _10"> </span>que <span class="blank _7"> </span>a <span class="blank _10"> </span>necessidade <span class="blank _7"> </span>d<span class="blank _1"> </span>e <span class="blank _7"> </span>folato <span class="blank _7"> </span>aumenta </span></div><div class="t m0 x9 h4 y182 ff2 fs2 fc0 sc0 ls7 ws3">substancialmente <span class="blank _10"> </span>durante <span class="blank _10"> </span>a <span class="blank _9"> </span>gestação. <span class="blank _10"> </span>A <span class="blank _10"> </span>deficiência <span class="blank _10"> </span>de </div><div class="t m0 x9 h4 y183 ff2 fs2 fc0 sc0 ls7 ws3">folato <span class="blank _4"> </span>na <span class="blank _4"> </span>gestante <span class="blank _4"> </span>tem <span class="blank _4"> </span>sido <span class="blank _4"> </span>rel<span class="blank _1"> </span>acionada <span class="blank _4"> </span>a <span class="blank _4"> </span>diversas </div><div class="t m0 x9 h4 y184 ff2 fs2 fc0 sc0 ls7 ws3">alterações, <span class="blank _1"> </span>EXCETO <span class="blank _1"> </span>(P<span class="blank _1"> </span>MRJ <span class="blank _1"> </span>2010): <span class="blank _2"> </span>(A) <span class="blank _2"> </span>sangramento <span class="blank _1"> </span>no </div><div class="t m0 x9 h4 y185 ff2 fs2 fc0 sc0 ls7 ws3">terceiro <span class="blank _16"> </span>trimestre <span class="blank _21"> </span>e <span class="blank _16"> </span>descolamento <span class="blank _21"> </span>placenta. <span class="blank _16"> </span>(B) </div><div class="t m0 x9 h4 y186 ff2 fs2 fc0 sc0 ls7 ws3">hipertensão <span class="blank _1"> </span>especifica <span class="blank _1"> </span>da <span class="blank _1"> </span>gravidez <span class="blank _1"> </span>e <span class="blank _1"> </span>p<span class="blank _1"> </span>rematuridade. <span class="blank _1"> </span>(C) </div><div class="t m0 x9 h4 y187 ff2 fs2 fc0 sc0 ls7 ws3">hidrocefalia <span class="blank _1"> </span>e <span class="blank _2"> </span>baixo <span class="blank _1"> </span>pes<span class="blank _1"> </span>o <span class="blank _1"> </span>ao <span class="blank _1"> </span>nascer. <span class="blank _2"> </span>(D) <span class="blank _1"> </span>m<span class="blank _1"> </span>acrossomia <span class="blank _1"> </span>e </div><div class="t m0 x9 h4 y188 ff2 fs2 fc0 sc0 ls7 ws3">anemia sideroblástica. </div><div class="t m0 x9 h4 y189 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y18a ff2 fs2 fc0 sc0 ls7 ws3">28) A <span class="blank _1"> </span>vitamina <span class="blank _1"> </span>que tem <span class="blank _1"> </span>seu requerimento aumentado <span class="blank _1"> </span>na </div><div class="t m0 x9 h4 y18b ff2 fs2 fc0 sc0 ls7 ws3">gravidez <span class="blank _1"> </span>e <span class="blank _1"> </span>é<span class="blank _1"> </span> <span class="blank _1"> </span>capaz <span class="blank _1"> </span>de <span class="blank _1"> </span>prevenir <span class="blank _1"> </span>a <span class="blank _1"> </span>d<span class="blank _1"> </span>epressão <span class="blank _1"> </span>gestacional </div><div class="t m0 x9 h4 y18c ff2 fs2 fc0 sc0 ls7 ws3">e pós gestacional é denominada (UERJ)<span class="lsb">: </span> </div><div class="t m0 x9 h4 y18d ff2 fs2 fc0 sc0 ls7 ws3">(A) tiamina (C) ácidofólico </div><div class="t m0 x9 h4 y18e ff2 fs2 fc0 sc0 ls7 ws3">(B) piridoxina (D) cianocobalamina </div><div class="t m0 x9 h4 y18f ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y190 ff2 fs2 fc0 sc0 ls7 ws3">29) <span class="blank _1"> </span>Os re<span class="blank _1"> </span>querimentos de <span class="blank _1"> </span>ferro durante <span class="blank _1"> </span>a <span class="blank _1"> </span>gestação es<span class="blank _1"> </span>tão </div><div class="t m0 x9 h4 y191 ff2 fs2 fc0 sc0 ls7 ws3">aumentados <span class="blank _e"> </span>em <span class="blank _e"> </span>função<span class="blank _1"> </span> <span class="blank _e"> </span>dos <span class="blank _e"> </span>seguintes <span class="blank _e"> </span>aspectos, </div><div class="t m0 x9 h4 y192 ff2 fs2 fc0 sc0 ls7 ws3">EXCETO (UFRJ 2011): </div><div class="t m0 x9 h4 y193 ff2 fs2 fc0 sc0 ls7 ws3">(A) <span class="blank _c"> </span>há <span class="blank _c"> </span>expansão <span class="blank _c"> </span>da <span class="blank _c"> </span>massa <span class="blank _d"> </span>eri<span class="blank _1"> </span>trocitária <span class="blank _c"> </span>durante <span class="blank _c"> </span>a </div><div class="t m0 x9 h4 yb2 ff2 fs2 fc0 sc0 ls7 ws3">gestação </div><div class="t m0 x9 h4 y194 ff2 fs2 fc0 sc0 ls7 ws3">(B) <span class="blank _c"> </span>há <span class="blank _c"> </span>redução <span class="blank _c"> </span>da <span class="blank _c"> </span>absorção <span class="blank _c"> </span>de<span class="blank _1"> </span> <span class="blank _c"> </span>ferro <span class="blank _c"> </span>no <span class="blank _c"> </span>terceiro </div><div class="t m0 x9 h4 y195 ff2 fs2 fc0 sc0 ls7 ws3">trimestre de gestação </div><div class="t m0 x9 h4 y196 ff2 fs2 fc0 sc0 ls7 ws3">(C) há formação da placenta </div><div class="t m0 x9 h4 y197 ff2 fs2 fc0 sc0 ls7 ws3">(D) há perdas basais de ferro durante a gestação </div><div class="t m0 x9 h4 y198 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y199 ff2 fs2 fc0 sc0 ls1">30<span class="ls7 ws3">) <span class="blank _7"> </span>A <span class="blank _7"> </span>Residente <span class="blank _7"> </span>d<span class="blank _0"></span>e <span class="blank _7"> </span>Nutrição <span class="blank _2"> </span>d<span class="blank _1"> </span>a <span class="blank _7"> </span>área <span class="blank _7"> </span>mater<span class="blank _0"></span>no <span class="blank _7"> </span><span class="ff4 ls1">\u2013</span> <span class="blank _7"> </span>infantil </span></div><div class="t m0 x9 h4 y19a ff2 fs2 fc0 sc0 ls7 ws3">de <span class="blank _2"> </span>um <span class="blank _2"> </span>hospital <span class="blank _2"> </span>universitário <span class="blank _2"> </span>foi<span class="blank _1"> </span> <span class="blank _1"> </span>c<span class="blank _1"> </span>onvidada <span class="blank _1"> </span>p<span class="blank _1"> </span>ara <span class="blank _1"> </span>conduzir </div><div class="t m0 x9 h4 y19b ff2 fs2 fc0 sc0 ls7 ws3">um <span class="blank _6"> </span>curso <span class="blank _5"> </span>de <span class="blank _6"> </span>gestantes <span class="blank _6"> </span>direcionado <span class="blank _6"> </span>à <span class="blank _5"> </span>jovens, <span class="blank _6"> </span>no <span class="blank _5"> </span>1o </div><div class="t m0 x9 h4 y19c ff2 fs2 fc0 sc0 ls7 ws3">trimestre <span class="blank _3"> </span>de <span class="blank _8"> </span>gestação, <span class="blank"> </span>com <span class="blank _9"> </span>idade <span class="blank"> </span>média <span class="blank _8"> </span>de <span class="blank _3"> </span>14 <span class="blank _8"> </span>anos. </div><div class="t m0 x9 h4 y19d ff2 fs2 fc0 sc0 ls7 ws3">Uma <span class="blank _8"> </span>d<span class="blank _1"> </span>as <span class="blank _8"> </span>temáticas <span class="blank _8"> </span>foi<span class="blank _1"> </span> <span class="blank _9"> </span>a<span class="blank _1"> </span> <span class="blank _8"> </span>importância <span class="blank _8"> </span>d<span class="blank _1"> </span>o <span class="blank _8"> </span>cálcio <span class="blank _3"> </span>e <span class="blank _8"> </span>sua </div><div class="t m0 x9 h4 y19e ff2 fs2 fc0 sc0 ls7 ws3">recomendação de ingestão diária mínima. </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1 y19f w8 hf" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg5.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">290 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">Em <span class="blank _7"> </span>um<span class="blank _1"> </span> <span class="blank _7"> </span>dos <span class="blank _7"> </span>exemplos <span class="blank _10"> </span>para <span class="blank _7"> </span>atingir <span class="blank _7"> </span>es<span class="blank _1"> </span>ta <span class="blank _10"> </span>recomendação, </div><div class="t m0 x1 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">as <span class="blank _2"> </span>jo<span class="blank _1"> </span>vens <span class="blank _2"> </span>foram <span class="blank _2"> </span>orientadas <span class="blank _2"> </span>a <span class="blank _7"> </span>consumir <span class="blank _2"> </span>leite <span class="blank _2"> </span>i<span class="blank _1"> </span>ntegral <span class="blank _2"> </span>em </div><div class="t m0 x1 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3">uma quantidade mínima, em ml, de(HUPE): </div><div class="t m0 x1 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">(A) 650 </div><div class="t m0 x1 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">(B) 850 </div><div class="t m0 x1 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">(C) 1050 </div><div class="t m0 x1 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">(D) 1250 </div><div class="t m0 x1 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h10 y1a0 ff2 fs7 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y1a1 ff2 fs2 fc0 sc0 ls7 ws3">31) <span class="blank _1"> </span>A anemia <span class="blank _1"> </span>materna, frequente <span class="blank _1"> </span>em <span class="blank _1"> </span>algumas gestantes </div><div class="t m0 x1 h4 y1a2 ff2 fs2 fc0 sc0 ls7 ws3">que <span class="blank _8"> </span>não <span class="blank _9"> </span>utilizam <span class="blank _8"> </span>suplementos <span class="blank _9"> </span>de <span class="blank _8"> </span>ferro, <span class="blank _8"> </span>é <span class="blank _9"> </span>definida <span class="blank _8"> </span>po<span class="blank _1"> </span><span class="lse">r </span></div><div class="t m0 x1 h4 y1a3 ff2 fs2 fc0 sc0 ls7 ws3">um <span class="blank _d"> </span>valor <span class="blank _d"> </span>de <span class="blank _d"> </span>hematócrito <span class="blank _4"> </span>e <span class="blank _d"> </span>hemoglobina, <span class="blank _d"> </span>inferiores, </div><div class="t m0 x1 h4 y1a4 ff2 fs2 fc0 sc0 ls7 ws3">respectivamente <span class="blank _9"> </span>(Marinha <span class="blank _9"> </span>2006): <span class="blank _9"> </span>(A)40% <span class="blank _9"> </span>e <span class="blank _9"> </span>13g/dL <span class="blank _9"> </span>(B) </div><div class="t m0 x1 h4 y1a5 ff2 fs2 fc0 sc0 ls7 ws3">38% e 12 g/dL (C)36% e 12g/dL (D) 34% e 11g/dL </div><div class="t m0 x1 h4 y1a6 ff2 fs2 fc0 sc0 ls7 ws3">(E) 32% e 11g/dL </div><div class="t m0 x1 h4 y1a7 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y1a8 ff2 fs2 fc0 sc0 ls7 ws3">32) <span class="blank _1a"> </span>Sobre <span class="blank _14"> </span>as <span class="blank _1a"> </span>reco<span class="blank _0"></span>mendações <span class="blank _1a"> </span>nutricionais <span class="blank _14"> </span>para <span class="blank _14"> </span>a </div><div class="t m0 x1 h4 y1a9 ff2 fs2 fc0 sc0 ls7 ws3">prevenção <span class="blank _9"> </span>da <span class="blank _9"> </span>anemia <span class="blank _10"> </span>ferropriva, <span class="blank _10"> </span>não<span class="blank _1"> </span> <span class="blank _10"> </span>é <span class="blank _8"> </span>correto <span class="blank _9"> </span>afirma<span class="lse">r </span></div><div class="t m0 x1 h4 y1aa ff2 fs2 fc0 sc0 ls7 ws3">que (Ministério da Saúde): </div><div class="t m0 x1 h4 y1ab ff2 fs2 fc0 sc0 ls7 ws3">(A) <span class="blank"> </span>Gestan<span class="blank _1"> </span>tes <span class="blank"> </span>devem <span class="blank"> </span>receber <span class="blank _6"> </span>suplemento <span class="blank"> </span>de <span class="blank _6"> </span>ferro <span class="blank"> </span>a </div><div class="t m0 x1 h4 y1ac ff2 fs2 fc0 sc0 ls7 ws3">partir da 20ª semana de gestação; </div><div class="t m0 x1 h4 y1ad ff2 fs2 fc0 sc0 ls7 ws3">(B) <span class="blank _7"> </span>Deve-se <span class="blank _7"> </span>incentivar <span class="blank _7"> </span>o <span class="blank _7"> </span>al<span class="blank _0"></span>eitamento <span class="blank _7"> </span>materno <span class="blank _7"> </span>exclusivo<span class="blank _0"></span> </div><div class="t m0 x1 h4 y1ae ff2 fs2 fc0 sc0 ls7 ws3">nos primeiros seis meses de vida da criança; </div><div class="t m0 x1 h4 y1af ff2 fs2 fc0 sc0 ls7 ws3">(C) <span class="blank _2"> </span>Deve-se <span class="blank _7"> </span>evitar <span class="blank _1"> </span>o <span class="blank _2"> </span>u<span class="blank _1"> </span>so <span class="blank _2"> </span>de <span class="blank _2"> </span>leite <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>vaca <span class="blank _2"> </span>nos <span class="blank _2"> </span>primeiros </div><div class="t m0 x1 h4 y1b0 ff2 fs2 fc0 sc0 ls7 ws3">seis me<span class="blank _1"> </span>ses de <span class="blank _1"> </span>vida da <span class="blank _1"> </span>criança, mas a<span class="blank _1"> </span>pós este <span class="blank _1"> </span>período o </div><div class="t m0 x1 h4 y1b1 ff2 fs2 fc0 sc0 ls7 ws3">leite <span class="blank _7"> </span>mate<span class="blank _1"> </span>rno <span class="blank _7"> </span>deve <span class="blank _7"> </span>ser <span class="blank _10"> </span>substituído <span class="blank _7"> </span>g<span class="blank _1"> </span>radativamente <span class="blank _7"> </span>pelo </div><div class="t m0 x1 h4 y1b2 ff2 fs2 fc0 sc0 ls7 ws3">leite de vaca; </div><div class="t m0 x1 h4 y1b3 ff2 fs2 fc0 sc0 ls7 ws3">(D) <span class="blank"> </span>Deve-se <span class="blank"> </span>evitar <span class="blank"> </span>o <span class="blank _8"> </span>consumo <span class="blank"> </span>de <span class="blank"> </span>leite, <span class="blank"> </span>deriv<span class="blank _0"></span>ados <span class="blank"> </span>de </div><div class="t m0 x1 h4 y1b4 ff2 fs2 fc0 sc0 ls7 ws3">leite, chá preto e café no almoço e no jantar; </div><div class="t m0 x1 h4 y1b5 ff2 fs2 fc0 sc0 ls7 ws3">(E) <span class="blank _10"> </span>O <span class="blank _7"> </span>al<span class="blank _1"> </span>moço <span class="blank _10"> </span>e <span class="blank _10"> </span>o <span class="blank _10"> </span>janta<span class="blank _1"> </span>r <span class="blank _7"> </span>devem <span class="blank _10"> </span>ser <span class="blank _10"> </span>acom<span class="blank _1"> </span>panhados <span class="blank _7"> </span>de </div><div class="t m0 x1 h4 y1b6 ff2 fs2 fc0 sc0 ls7 ws3">algum <span class="blank _1"> </span>alimento <span class="blank _1"> </span>fonte de <span class="blank _1"> </span>vitamina <span class="blank _1"> </span>C <span class="blank _1"> </span>a <span class="blank _1"> </span>fim <span class="blank _1"> </span>de <span class="blank _1"> </span>aumentar a </div><div class="t m0 x1 h4 y1b7 ff2 fs2 fc0 sc0 ls7 ws3">biodisponibilidade do ferro não-heme da refeição. </div><div class="t m0 x1 h4 y1b8 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y1b9 ff2 fs2 fc0 sc0 ls7 ws3">33) <span class="blank _13"> </span>Considere <span class="blank _13"> </span>uma <span class="blank _13"> </span>gestante <span class="blank _13"> </span>com <span class="blank _13"> </span>12 <span class="blank _13"> </span>semanas </div><div class="t m0 x1 h4 y1ba ff2 fs2 fc0 sc0 ls7 ws3">gestacionais, <span class="blank"> </span>com <span class="blank _3"> </span>BP <span class="blank _3"> </span>pré <span class="blank"> </span>g<span class="blank _0"></span>estacional, <span class="blank"> </span>que <span class="blank _3"> </span>apresenta </div><div class="t m0 x1 h4 y1bb ff2 fs2 fc0 sc0 ls1 ws9">quadr<span class="ls7 ws3">o <span class="blank _14"> </span>de <span class="blank _1a"> </span>náuseas <span class="blank _14"> </span>e <span class="blank _14"> </span>vômitos. <span class="blank _1a"> </span>Para <span class="blank _14"> </span>amenizar <span class="blank _14"> </span>o </span></div><div class="t m0 x1 h4 y1bc ff2 fs2 fc0 sc0 ls7 ws3">desconforto <span class="blank _7"> </span>relatado, <span class="blank _2"> </span>deve<span class="blank _1"> </span>-se <span class="blank _2"> </span>sup<span class="blank _1"> </span>lementar <span class="blank _2"> </span>e <span class="blank _7"> </span>incentivar, </div><div class="t m0 x1 h4 y1bd ff2 fs2 fc0 sc0 ls7 ws3">respectivamente, <span class="blank _c"> </span>o <span class="blank _c"> </span>consumo <span class="blank _c"> </span>de <span class="blank _c"> </span>vitamina <span class="blank _c"> </span>(Marinha, </div><div class="t m0 x1 h4 y1be ff2 fs2 fc0 sc0 ls7 ws3">2011): </div><div class="t m0 x1 h4 y1bf ff2 fs2 fc0 sc0 ls7 ws3">(A) B12 e cravo </div><div class="t m0 x1 h4 y1c0 ff2 fs2 fc0 sc0 ls7 ws3">(B) B1 e gengibre </div><div class="t m0 x1 h4 y1c1 ff2 fs2 fc0 sc0 ls7 ws3">(C) B6 e cravo </div><div class="t m0 x1 h4 y1c2 ff2 fs2 fc0 sc0 ls7 ws3">(D) B1 e cravo </div><div class="t m0 x1 h4 y1c3 ff2 fs2 fc0 sc0 ls7 ws3">(E) B6 e gengibre </div><div class="t m0 x1 h4 y1c4 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y1c5 ff2 fs2 fc0 sc0 ls7 ws3">34) <span class="blank _2"> </span>A <span class="blank _2"> </span>ingestão <span class="blank _2"> </span>di<span class="blank _1"> </span>etética <span class="blank _1"> </span>de <span class="blank _2"> </span>referência <span class="blank _2"> </span>(IDR) <span class="blank _2"> </span>de <span class="blank _2"> </span>vitamina </div><div class="t m0 x1 h4 y1c6 ff2 fs2 fc0 sc0 ls7 ws3">A para a<span class="blank _1"> </span>dolescentes gestantes, com idade entre 1<span class="blank _1"> </span>4 e 18 </div><div class="t m0 x1 h4 y1c7 ff2 fs2 fc0 sc0 ls7 ws3">anos, é de (Degase, 2012): </div><div class="t m0 x1 h4 y1c8 ff4 fs2 fc0 sc0 ls7 ws3">A) 600\u03bcg/RE/dia<span class="ff2"> </span></div><div class="t m0 x1 h4 y1c9 ff4 fs2 fc0 sc0 ls7 ws3">B) 700\u03bcg/RE/dia<span class="ff2"> </span></div><div class="t m0 x1 h4 y1ca ff4 fs2 fc0 sc0 ls7 ws3">C) 650\u03bcg/RE/dia<span class="ff2"> </span></div><div class="t m0 x1 h4 y1cb ff4 fs2 fc0 sc0 ls7 ws3">D) 750\u03bcg/RE/dia<span class="ff2"> </span></div><div class="t m0 x1 h4 y1cc ff4 fs2 fc0 sc0 ls7 ws3">E) 500\u03bcg/RE/dia<span class="ff2"> </span></div><div class="t m0 x1 h4 y1cd ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y1ce ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y1cf ff2 fs2 fc0 sc0 ls7 ws3">35) <span class="blank _7"> </span>Dentre <span class="blank _7"> </span>as <span class="blank _7"> </span>deficiências <span class="blank _2"> </span>nutricionais <span class="blank _7"> </span>consideradas <span class="blank _7"> </span>de </div><div class="t m0 x1 h4 y1d0 ff2 fs2 fc0 sc0 ls7 ws3">risco <span class="blank _6"> </span>durante <span class="blank _6"> </span>a <span class="blank"> </span>gestação, <span class="blank _6"> </span>a <span class="blank _6"> </span>de <span class="blank _6"> </span>vitamina <span class="blank _6"> </span>A <span class="blank"> </span>tem <span class="blank _6"> </span>sido </div><div class="t m0 x1 h4 y1d1 ff2 fs2 fc0 sc0 ls7 ws3">destacada <span class="blank _14"> </span>na <span class="blank _14"> </span>l<span class="blank _1"> </span>iteratura, <span class="blank _14"> </span>e <span class="blank _14"> </span>a <span class="blank _14"> </span>ingestão <span class="blank _1a"> </span>desta <span class="blank _12"> </span>está </div><div class="t m0 x1 h4 y1d2 ff2 fs2 fc0 sc0 ls7 ws3">fortemente <span class="blank _21"> </span>associada <span class="blank _21"> </span>à <span class="blank _16"> </span>repro<span class="blank _1"> </span>dução <span class="blank _16"> </span>normal, <span class="blank _21"> </span>ao </div><div class="t m0 x1 h4 y1d3 ff2 fs2 fc0 sc0 ls7 ws3">crescimento <span class="blank _6"> </span>fetal, <span class="blank _6"> </span>à <span class="blank _6"> </span>c<span class="blank _1"> </span>onstituição <span class="blank"> </span>da<span class="blank _1"> </span> <span class="blank"> </span>reserva <span class="blank _5"> </span>hepática </div><div class="t m0 x1 h4 y1d4 ff2 fs2 fc0 sc0 ls7 ws3">fetal <span class="blank _5"> </span>e <span class="blank _a"> </span>ao <span class="blank _5"> </span>crescimento <span class="blank _5"> </span>te<span class="blank _1"> </span>cidual <span class="blank _5"> </span>materno. <span class="blank _5"> </span>Acredita<span class="blank _1"> </span>-se </div><div class="t m0 x1 h4 y1d5 ff2 fs2 fc0 sc0 ls7 ws3">também <span class="blank _7"> </span>que <span class="blank _10"> </span>esteja <span class="blank _7"> </span>envolvida <span class="blank _7"> </span>na <span class="blank _10"> </span>síntese <span class="blank _7"> </span>de<span class="blank _1"> </span> <span class="blank _7"> </span>hormônios </div><div class="t m0 x1 h4 y1d6 ff2 fs2 fc0 sc0 ls7 ws3">esteroides, <span class="blank _1e"> </span>te<span class="blank _1"> </span>ndo <span class="blank _1e"> </span>sido <span class="blank _1e"> </span>demonstrado <span class="blank _22"> </span>que <span class="blank _1e"> </span>a </div><div class="t m0 x1 h4 y1d7 ff2 fs2 fc0 sc0 ls7 ws3">suplementação <span class="blank"> </span>e<span class="blank _0"></span>m <span class="blank _3"> </span>níveis <span class="blank _3"> </span>seguros <span class="blank"> </span>d<span class="blank _0"></span>e <span class="blank _3"> </span>vitamina <span class="blank _3"> </span>A <span class="blank _8"> </span>tra<span class="blank _1"> </span>z </div><div class="t m0 x1 h4 y1d8 ff2 fs2 fc0 sc0 ls7 ws3">benefícios <span class="blank _9"> </span>para <span class="blank _10"> </span>a<span class="blank _1"> </span> <span class="blank _10"> </span>função <span class="blank _9"> </span>fetoplacentária <span class="blank _10"> </span>pelo <span class="blank _9"> </span>aumento </div><div class="t m0 x1 h4 y1d9 ff2 fs2 fc0 sc0 ls7 ws3">dos níveis de (São Gonçalo 2011): </div><div class="t m0 x1 h4 y1da ff2 fs2 fc0 sc0 ls7 ws3">A) prolactina </div><div class="t m0 x1 h4 y1db ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y1dc ff2 fs2 fc0 sc0 ls7 ws3">B) oxitocina </div><div class="t m0 x1 h4 y1dd ff2 fs2 fc0 sc0 ls7 ws3">C) progesterona. </div><div class="t m0 x1 h4 y1de ff2 fs2 fc0 sc0 ls7 ws3">D) estrogênio. </div><div class="t m0 x9 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">E) insulina. </div><div class="t m0 x9 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3">36) <span class="blank _8"> </span>De <span class="blank _8"> </span>acordo <span class="blank _8"> </span>com<span class="blank _1"> </span> <span class="blank _9"> </span>a <span class="blank _8"> </span>FAO/OMS, <span class="blank _8"> </span>2004, <span class="blank _3"> </span>a <span class="blank _9"> </span>d<span class="blank _1"> </span>istribuição<span class="blank _0"></span> </div><div class="t m0 x9 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">energética diária do adicional energético no 1º trimestre </div><div class="t m0 x9 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">(idade <span class="blank _4"> </span>gestacional<14 <span class="blank _4"> </span>sema<span class="blank _0"></span>nas), <span class="blank _4"> </span>2º <span class="blank _4"> </span>trimestre <span class="blank _a"> </span>(i<span class="blank _1"> </span>dade </div><div class="t m0 x9 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank _7"> </span>>=14 <span class="blank _7"> </span>a<span class="blank _0"></span> <span class="blank _7"> </span><28 <span class="blank _2"> </span>sem<span class="blank _1"> </span>anas) <span class="blank _2"> </span>e <span class="blank _7"> </span>3º <span class="blank _7"> </span>trimestre <span class="blank _7"> </span>(idad<span class="blank _0"></span>e </div><div class="t m0 x9 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank _7"> </span>>=28 <span class="blank _2"> </span>semanas) <span class="blank _7"> </span>são, <span class="blank _2"> </span>res<span class="blank _1"> </span>pectivamente <span class="blank _2"> </span>(SES </div><div class="t m0 x9 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3">2011): </div><div class="t m0 x9 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">A) 100 Kcal/dia, 285 Kcal/dia e 575 Kcal/dia </div><div class="t m0 x9 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">B) 85 Kcal/dia, 285 Kcal/dia e 475 Kcal/dia </div><div class="t m0 x9 h4 y50 ff2 fs2 fc0 sc0 ls7 ws3">C) 185 Kcal/dia, 355 Kcal/dia e 575 Kcal/dia </div><div class="t m0 x9 h4 y51 ff2 fs2 fc0 sc0 ls7 ws3">D) 85 Kcal/dia, 385 Kcal/dia e 575 Kcal/dia </div><div class="t m0 x9 h4 y52 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y53 ff2 fs2 fc0 sc0 ls7 ws3">37) <span class="blank _d"> </span>Segundo <span class="blank _4"> </span>o<span class="blank _1"> </span>rientações <span class="blank _4"> </span>publicadas <span class="blank _d"> </span>no <span class="blank _4"> </span>Manual <span class="blank _d"> </span>do </div><div class="t m0 x9 h4 y54 ff2 fs2 fc0 sc0 ls7 ws3">Sistema <span class="blank _2"> </span>de <span class="blank _2"> </span>Vigilância <span class="blank _2"> </span>Alimentar <span class="blank _1"> </span>e <span class="blank _2"> </span>Nut<span class="blank _1"> </span>ricional <span class="blank _1"> </span>(SISVAN), </div><div class="t m0 x9 h4 y55 ff2 fs2 fc0 sc0 ls7 ws3">do <span class="blank _2"> </span>Ministério <span class="blank _2"> </span>da <span class="blank _2"> </span>Saúde, <span class="blank _2"> </span>o<span class="blank _1"> </span> <span class="blank _1"> </span>ganho <span class="blank _2"> </span>de <span class="blank _2"> </span>peso <span class="blank _2"> </span>recomendado </div><div class="t m0 x9 h4 y56 ff2 fs2 fc0 sc0 ls7 ws3">durante <span class="blank _1"> </span>a gestação <span class="blank _1"> </span>depende do <span class="blank _1"> </span>estado nutricional <span class="blank _1"> </span>inicial </div><div class="t m0 x9 h4 y57 ff2 fs2 fc0 sc0 ls7 ws3">da <span class="blank _10"> </span>mulher. <span class="blank _10"> </span>É <span class="blank _10"> </span>recomendável <span class="blank _7"> </span>o <span class="blank _10"> </span>seguinte <span class="blank _10"> </span>ganho <span class="blank _10"> </span>de <span class="blank _7"> </span>pe<span class="blank _1"> </span>so </div><div class="t m0 x9 h4 y58 ff2 fs2 fc0 sc0 ls7 ws3">total, <span class="blank _7"> </span>em <span class="blank _7"> </span>Kg, <span class="blank _2"> </span>para <span class="blank _7"> </span>o <span class="blank _7"> </span>primeiro <span class="blank _2"> </span>trimestre, <span class="blank _7"> </span>e <span class="blank _7"> </span>semanal <span class="blank _2"> </span>p<span class="blank _1"> </span>ara </div><div class="t m0 x9 h4 y59 ff2 fs2 fc0 sc0 ls7 ws3">os <span class="blank _2"> </span>segundo <span class="blank _2"> </span>e <span class="blank _7"> </span>ter<span class="blank _0"></span>ceiro <span class="blank _2"> </span>trimestres, <span class="blank _7"> </span>r<span class="blank _0"></span>espectivamente, <span class="blank _2"> </span>para </div><div class="t m0 x9 h4 y5a ff2 fs2 fc0 sc0 ls7 ws3">uma <span class="blank _8"> </span>mulher <span class="blank _8"> </span>que <span class="blank _8"> </span>tenha <span class="blank _8"> </span>iniciado <span class="blank _8"> </span>a <span class="blank _8"> </span>g<span class="blank _1"> </span>estação <span class="blank _9"> </span>com <span class="blank _8"> </span>peso </div><div class="t m0 x9 h4 y5b ff2 fs2 fc0 sc0 ls7 ws3">adequado (Prefeitura de Petrópolis, 2012): </div><div class="t m0 x9 h4 y5c ff2 fs2 fc0 sc0 ls7 ws3">A) 2,3 e 0,5. </div><div class="t m0 x9 h4 y5d ff2 fs2 fc0 sc0 ls7 ws3">B) 4,5 e 8,5. </div><div class="t m0 x9 h4 ye6 ff2 fs2 fc0 sc0 ls7 ws3">C) 0,9 e 0,3. </div><div class="t m0 x9 h4 y5e ff2 fs2 fc0 sc0 ls7 ws3">D) 1,6 e 0,4. </div><div class="t m0 x9 h4 y5f ff2 fs2 fc0 sc0 ls7 ws3">E) 3,5 e 8,5. </div><div class="t m0 x9 h4 y60 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y61 ff2 fs2 fc0 sc0 ls7 ws3">38) <span class="blank _a"> </span>O <span class="blank _a"> </span>IOM <span class="blank _a"> </span>(Insti<span class="blank _1"> </span>tute <span class="blank _5"> </span>o<span class="blank _1"> </span>f <span class="blank _a"> </span>Medicine) <span class="blank _a"> </span>estabeleceu <span class="blank _5"> </span>a<span class="blank _1"> </span> <span class="blank _5"> </span>Al </div><div class="t m0 x9 h4 y62 ff2 fs2 fc0 sc0 ls7 ws3">(Ingestão <span class="blank _c"> </span>Adequada) <span class="blank _c"> </span>para <span class="blank _d"> </span>a <span class="blank _c"> </span>quantidade <span class="blank _c"> </span>de <span class="blank _c"> </span>ácidos </div><div class="t m0 x9 h4 ye7 ff2 fs2 fc0 sc0 ls7 ws3">graxos <span class="blank _15"> </span>ôm<span class="blank _1"> </span>ega-6 <span class="blank _15"> </span>e <span class="blank _23"> </span>ômega-3 <span class="blank _23"> </span>para <span class="blank _15"> </span>gestantes, </div><div class="t m0 x9 h4 ye8 ff2 fs2 fc0 sc0 ls7 ws3">respectivamente, em (Marinha, 2017): </div><div class="t m0 x9 h4 ye9 ff2 fs2 fc0 sc0 ls7 ws3">(A) 25 e 2,0 g/dia. </div><div class="t m0 x9 h4 yea ff2 fs2 fc0 sc0 ls7 ws3">(B) 20 e 1,5 g/dia. </div><div class="t m0 x9 h4 y9e ff2 fs2 fc0 sc0 ls7 ws3">(C) 20 e 2,0 g/dia. </div><div class="t m0 x9 h4 yeb ff2 fs2 fc0 sc0 ls7 ws3">(D) 15 e 2,0 g/dia. </div><div class="t m0 x9 h4 yec ff2 fs2 fc0 sc0 ls7 ws3">(E) 13 e 1,4 g/dia. </div><div class="t m0 x9 h4 yed ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 yee ff2 fs2 fc0 sc0 ls7 ws3">39) <span class="blank _12"> </span>Qual<span class="blank _1"> </span> <span class="blank _12"> </span>é <span class="blank _14"> </span>a <span class="blank _12"> </span>quantidade <span class="blank _12"> </span>diá<span class="blank _1"> </span>ria <span class="blank _12"> </span>recomendada <span class="blank _12"> </span>de </div><div class="t m0 x9 h4 yef ff2 fs2 fc0 sc0 ls7 ws3">ingestão <span class="blank _10"> </span>de <span class="blank _10"> </span>ácid<span class="blank _1"> </span>o-docosa-hex<span class="blank _0"></span>aenoico <span class="blank _9"> </span>(DHA) <span class="blank _10"> </span>durante <span class="blank _10"> </span>a </div><div class="t m0 x9 h4 yf0 ff2 fs2 fc0 sc0 ls7 ws3">gestação <span class="blank _10"> </span>(Marinha, <span class="blank _9"> </span>2017)? <span class="blank _10"> </span>(A) <span class="blank _10"> </span>200mg. <span class="blank _9"> </span>(B) <span class="blank _10"> </span>500mg. <span class="blank _10"> </span>(C) </div><div class="t m0 x9 h4 yf1 ff2 fs2 fc0 sc0 ls7 ws3">800mg. (D) 1000mg. (E) 2000mg </div><div class="t m0 x9 h4 yf2 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 yf3 ff2 fs2 fc0 sc0 ls7 ws3">40) Qual é a média de ganho de peso durante o primeiro </div><div class="t m0 x9 h4 yf4 ff2 fs2 fc0 sc0 ls7 ws3">trimestre <span class="blank _1"> </span>de <span class="blank _1"> </span>gestação? <span class="blank _1"> </span>(A) <span class="blank _1"> </span>1 <span class="blank _1"> </span>a <span class="blank _1"> </span>2kg<span class="blank _1"> </span> <span class="blank _1"> </span>(B) 2 <span class="blank _2"> </span>a <span class="blank _1"> </span>2,5kg <span class="blank _1"> </span>(C) <span class="blank _1"> </span>2,5 </div><div class="t m0 x9 h4 yf5 ff2 fs2 fc0 sc0 ls7 ws3">a 3,5kg (D) 3 a 4kg (E) 4 a 4,5kg </div><div class="t m0 x9 h4 yf6 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 yf7 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 hb y1df ff3 fs2 fc0 sc0 ls7 ws3">GABARITO: </div><div class="t m0 x9 hb y1e0 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="c xc y1e1 w9 h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">1 C<span class="ls7"> </span></div></div><div class="c xd y1e1 wa h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">11 C<span class="ls7"> </span></div></div><div class="c xe y1e1 wb h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">21 B<span class="ls7"> </span></div></div><div class="c xf y1e1 wa h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">31 E<span class="ls7"> </span></div></div><div class="c x10 y1e1 w9 h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1e1 wc h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1e3 w9 h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">2 B<span class="ls7"> </span></div></div><div class="c xd y1e3 wa h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">12 C<span class="ls7"> </span></div></div><div class="c xe y1e3 wb h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">22 B<span class="ls7"> </span></div></div><div class="c xf y1e3 wa h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls13 ws3">32 C<span class="ls7"> </span></div></div><div class="c x10 y1e3 w9 h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1e3 wc h11"><div class="t m0 x5 h12 y1e2 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1e4 w9 h13"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">3 A<span class="ls7"> </span></div></div><div class="c xd y1e4 wa h13"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">13 A<span class="ls7"> </span></div></div><div class="c xe y1e4 wb h13"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">23 D<span class="ls7"> </span></div></div><div class="c xf y1e4 wa h13"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">33 E<span class="ls7"> </span></div></div><div class="c x10 y1e4 w9 h13"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1e4 wc h13"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1e6 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">4 D<span class="ls7"> </span></div></div><div class="c xd y1e6 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">14 D<span class="ls7"> </span></div></div><div class="c xe y1e6 wb h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">24 B<span class="ls7"> </span></div></div><div class="c xf y1e6 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">34 D<span class="ls7"> </span></div></div><div class="c x10 y1e6 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1e6 wc h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1e7 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">5 B<span class="ls7"> </span></div></div><div class="c xd y1e7 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">15 D<span class="ls7"> </span></div></div><div class="c xe y1e7 wb h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">25 A<span class="ls7"> </span></div></div><div class="c xf y1e7 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">35 C<span class="ls7"> </span></div></div><div class="c x10 y1e7 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1e7 wc h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1e8 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">6 A<span class="ls7"> </span></div></div><div class="c xd y1e8 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">16 B<span class="ls7"> </span></div></div><div class="c xe y1e8 wb h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">26 C<span class="ls7"> </span></div></div><div class="c xf y1e8 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">36 B<span class="ls7"> </span></div></div><div class="c x10 y1e8 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1e8 wc h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1e9 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">7 D<span class="ls7"> </span></div></div><div class="c xd y1e9 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">17 D<span class="ls7"> </span></div></div><div class="c xe y1e9 wb h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">27 D<span class="ls7"> </span></div></div><div class="c xf y1e9 wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">37 D<span class="ls7"> </span></div></div><div class="c x10 y1e9 w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1e9 wc h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1ea w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">8 D<span class="ls7"> </span></div></div><div class="c xd y1ea wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">18 D<span class="ls7"> </span></div></div><div class="c xe y1ea wb h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">28 B<span class="ls7"> </span></div></div><div class="c xf y1ea wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">38 D<span class="ls7"> </span></div></div><div class="c x10 y1ea w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1ea wc h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1eb w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">9 B<span class="ls7"> </span></div></div><div class="c xd y1eb wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">19 E<span class="ls7"> </span></div></div><div class="c xe y1eb wb h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">29 B<span class="ls7"> </span></div></div><div class="c xf y1eb wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">39 A<span class="ls7"> </span></div></div><div class="c x10 y1eb w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1eb wc h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c xc y1ec w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">10 D<span class="ls7"> </span></div></div><div class="c xd y1ec wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">20 A<span class="ls7"> </span></div></div><div class="c xe y1ec wb h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">30 C<span class="ls7"> </span></div></div><div class="c xf y1ec wa h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls13 ws3">40 A<span class="ls7"> </span></div></div><div class="c x10 y1ec w9 h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="c x11 y1ec wc h11"><div class="t m0 x5 h12 y1e5 ff2 fs8 fc0 sc0 ls7 ws3"> </div></div><div class="t m0 x9 hb y1ed ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 hb y1ee ff3 fs2 fc0 sc0 ls7 ws3"> </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf6" class="pf w0 h0" data-page-no="6"><div class="pc pc6 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1 y1ef w7 h14" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg6.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">291 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h5 y1f0 ff3 fs3 fc0 sc0 ls14 ws3"> <span class="ls7 v4">GESTANTE <span class="blank _1"> </span>ADOLESCENTE </span></div><div class="t m0 x1 h5 y1f1 ff3 fs3 fc0 sc0 ls15 ws3"> <span class="ff2 fs2 ls7 v5">Entende-se <span class="blank _9"> </span>por <span class="blank _9"> </span>adolescente <span class="blank _9"> </span>o <span class="blank _9"> </span>indivíduo <span class="blank _9"> </span>com <span class="blank _9"> </span>idade </span></div><div class="t m0 x1 h4 y1f2 ff2 fs2 fc0 sc0 ls7 ws3">entre <span class="blank _10"> </span>de <span class="blank _10"> </span>10 <span class="blank _10"> </span>e <span class="blank _9"> </span>19 <span class="blank _10"> </span>anos. <span class="blank _10"> </span>É <span class="blank _10"> </span>um <span class="blank _10"> </span>período <span class="blank _9"> </span>de <span class="blank _7"> </span>cre<span class="blank _1"> </span>scimento, </div><div class="t m0 x1 h4 y1f3 ff2 fs2 fc0 sc0 ls7 ws3">maturação <span class="blank _7"> </span>e <span class="blank _7"> </span>estabelecimento <span class="blank _7"> </span>dos <span class="blank _7"> </span>padrões <span class="blank _7"> </span>adultos. <span class="blank _7"> </span>Em </div><div class="t m0 x1 h4 y1f4 ff2 fs2 fc0 sc0 ls7 ws3">apenas <span class="blank _13"> </span>2 <span class="blank _13"> </span>décadas, <span class="blank _17"> </span>a<span class="blank _0"></span> <span class="blank _13"> </span>idade <span class="blank _13"> </span>das <span class="blank _13"> </span>mu<span class="blank _1"> </span>lheres <span class="blank _13"> </span>ao </div><div class="t m0 x1 h4 y1f5 ff2 fs2 fc0 sc0 ls7 ws3">experimentarem <span class="blank _10"> </span>a <span class="blank _10"> </span>1º <span class="blank _9"> </span>relação <span class="blank _7"> </span>s<span class="blank _1"> </span>exual <span class="blank _10"> </span>reduziu <span class="blank _7"> </span>2<span class="blank _1"> </span> <span class="blank _10"> </span>an<span class="blank _1"> </span>os, <span class="blank _7"> </span>a </div><div class="t m0 x1 h4 y1f6 ff2 fs2 fc0 sc0 ls7 ws3">associação <span class="blank _1"> </span>da <span class="blank _1"> </span>precocidade <span class="blank _1"> </span>da <span class="blank _1"> </span>ini<span class="blank _1"> </span>ciação <span class="blank _1"> </span>sexual <span class="blank _1"> </span>feminina </div><div class="t m0 x1 h4 y1f7 ff2 fs2 fc0 sc0 ls7 ws3">à <span class="blank _9"> </span>falta <span class="blank _10"> </span>ou<span class="blank _1"> </span> <span class="blank _10"> </span>inadequação <span class="blank _9"> </span>das <span class="blank _10"> </span>informações <span class="blank _9"> </span>a <span class="blank _9"> </span>respeito <span class="blank _10"> </span>da </div><div class="t m0 x1 h4 y1f8 ff2 fs2 fc0 sc0 ls7 ws3">sexualidade <span class="blank _1"> </span>e <span class="blank _1"> </span>uso <span class="blank _2"> </span>dos <span class="blank _1"> </span>métodos <span class="blank _1"> </span>contraceptivos <span class="blank _1"> </span>tem <span class="blank _1"> </span>s<span class="blank _1"> </span>ido </div><div class="t m0 x1 h4 y1f9 ff2 fs2 fc0 sc0 ls7 ws3">apontada <span class="blank _e"> </span>como <span class="blank _13"> </span>principal <span class="blank _e"> </span>causa <span class="blank _e"> </span>da <span class="blank _13"> </span>gravidez <span class="blank _e"> </span>na </div><div class="t m0 x1 h4 y1fa ff2 fs2 fc0 sc0 ls7 ws3">adolescência (Accioly). </div><div class="t m0 x1 h4 y1fb ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y1fc ff3 fs2 fc0 sc0 ls7 ws3">Aspectos epidemiológicos <span class="ff2">(Accioly) </span></div><div class="t m0 x3 h4 y1fd ff2 fs2 fc0 sc0 ls7 ws3"> No <span class="blank"> </span>mundo, <span class="blank"> </span>a <span class="blank"> </span>c<span class="blank _1"> </span>ada <span class="blank"> </span>ano <span class="blank"> </span>cerca <span class="blank"> </span>de <span class="blank"> </span>15 <span class="blank _6"> </span>milhões <span class="blank"> </span>de </div><div class="t m0 x1 h4 y1fe ff2 fs2 fc0 sc0 ls7 ws3">mulheres <span class="blank _7"> </span>de <span class="blank _2"> </span>15 <span class="blank _7"> </span>a <span class="blank _2"> </span>19<span class="blank _1"> </span> <span class="blank _2"> </span>anos <span class="blank _7"> </span>de <span class="blank _2"> </span>idad<span class="blank _1"> </span>e <span class="blank _2"> </span>têm <span class="blank _7"> </span>filhos, <span class="blank _7"> </span>De<span class="blank _0"></span>stas, </div><div class="t m0 x1 h4 y1ff ff2 fs2 fc0 sc0 ls7 ws3">80% <span class="blank _9"> </span>vivem <span class="blank _9"> </span>em<span class="blank _1"> </span> <span class="blank _9"> </span>países <span class="blank _9"> </span>em <span class="blank _9"> </span>desenvolvimento. <span class="blank _9"> </span>No <span class="blank _9"> </span>Bra<span class="blank _1"> </span>sil </div><div class="t m0 x1 h4 y200 ff2 fs2 fc0 sc0 ls7 ws3">houve <span class="blank _9"> </span>aumento <span class="blank _8"> </span>da <span class="blank _8"> </span>tax<span class="blank _0"></span>a <span class="blank _9"> </span>d<span class="blank _1"> </span>e <span class="blank _9"> </span>fecundidade <span class="blank _9"> </span>e <span class="blank _8"> </span>25% <span class="blank _8"> </span>das <span class="blank _9"> </span>5 </div><div class="t m0 x1 h4 y201 ff2 fs2 fc0 sc0 ls7 ws3">milhões <span class="blank _8"> </span>de<span class="blank _1"> </span> <span class="blank _8"> </span>internações <span class="blank _8"> </span>por <span class="blank _3"> </span>gravidez <span class="blank _8"> </span>no <span class="blank"> </span>SUS, <span class="blank _8"> </span>são <span class="blank _3"> </span>de </div><div class="t m0 x1 h4 y202 ff2 fs2 fc0 sc0 ls7 ws3">adolescentes. <span class="blank _7"> </span>A <span class="blank _10"> </span>taxa <span class="blank _7"> </span>de <span class="blank _10"> </span>mortalidade <span class="blank _7"> </span>materna <span class="blank _7"> </span>varia <span class="blank _10"> </span>em </div><div class="t m0 x1 h4 y203 ff2 fs2 fc0 sc0 ls7 ws3">torno <span class="blank _10"> </span>de<span class="blank _1"> </span> <span class="blank _10"> </span>20% <span class="blank _9"> </span>nos <span class="blank _9"> </span>EUA <span class="blank _10"> </span>e <span class="blank _9"> </span>50% <span class="blank _9"> </span>na <span class="blank _9"> </span>América <span class="blank _10"> </span>Latina. <span class="blank _9"> </span>No </div><div class="t m0 x1 h4 y204 ff2 fs2 fc0 sc0 ls7 ws3">Brasil, <span class="blank _d"> </span>a <span class="blank _d"> </span>mortalidade <span class="blank _4"> </span>materna <span class="blank _d"> </span>fica <span class="blank _d"> </span>em <span class="blank _d"> </span>3º <span class="blank _4"> </span>l<span class="blank _1"> </span>ugar <span class="blank _4"> </span>no </div><div class="t m0 x1 h4 y205 ff2 fs2 fc0 sc0 ls7 ws3">ranking <span class="blank _8"> </span>d<span class="blank _1"> </span>e <span class="blank _8"> </span>óbitos <span class="blank _8"> </span>de <span class="blank _3"> </span>adolescentes, <span class="blank _8"> </span>perdendo <span class="blank"> </span>s<span class="blank _0"></span>ó <span class="blank _8"> </span>para </div><div class="t m0 x1 h4 y206 ff2 fs2 fc0 sc0 ls7 ws3">acidentes no trânsito e homicídios. </div><div class="t m0 x3 h4 y207 ff2 fs2 fc0 sc0 ls7 ws3">Dados <span class="blank _d"> </span>do <span class="blank _d"> </span>MS <span class="blank _d"> </span>mostram <span class="blank _d"> </span>que <span class="blank _d"> </span>houve <span class="blank _d"> </span>redução <span class="blank _d"> </span>na </div><div class="t m0 x1 h4 y208 ff2 fs2 fc0 sc0 ls7 ws3">prevalência <span class="blank"> </span>de <span class="blank"> </span>part<span class="blank _0"></span>os <span class="blank"> </span>entre <span class="blank _3"> </span>mães <span class="blank"> </span>com <span class="blank _3"> </span>menos <span class="blank"> </span>de <span class="blank _3"> </span>20 </div><div class="t m0 x1 h4 y209 ff2 fs2 fc0 sc0 ls7 ws3">anos de 23,9% para 19,3% (Vitolo). </div><div class="t m0 x1 hb y179 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y17a ff3 fs2 fc0 sc0 ls7 ws3">Características do adolescente </div><div class="t m0 x3 h4 y20a ff2 fs2 fc0 sc0 ls7 ws3">Há <span class="blank _7"> </span>o <span class="blank _7"> </span>alcance <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>45%<span class="blank _1"> </span> <span class="blank _7"> </span>d<span class="blank _0"></span>o <span class="blank _7"> </span>crescimento, <span class="blank _7"> </span>aquisição <span class="blank _7"> </span>d<span class="blank _0"></span>e </div><div class="t m0 x1 h4 y20b ff2 fs2 fc0 sc0 ls7 ws3">15 <span class="blank"> </span>a <span class="blank"> </span>25% <span class="blank"> </span>da <span class="blank"> </span>estatura <span class="blank _3"> </span>e <span class="blank"> </span>o <span class="blank"> </span>acúmulo <span class="blank"> </span>de <span class="blank"> </span>37% <span class="blank"> </span>de <span class="blank _8"> </span>s<span class="blank _1"> </span>ua </div><div class="t m0 x1 h4 y20c ff2 fs2 fc0 sc0 ls7 ws3">massa <span class="blank _2"> </span>óssea <span class="blank _2"> </span>adulta <span class="blank _2"> </span>(Accioly). <span class="blank _2"> </span>O <span class="blank _2"> </span>esti<span class="blank _1"> </span>rão <span class="blank _2"> </span>do <span class="blank _2"> </span>crescimento </div><div class="t m0 x1 h4 y20d ff2 fs2 fc0 sc0 ls7 ws3">ocorre <span class="blank _7"> </span>entre <span class="blank _7"> </span>10 <span class="blank _2"> </span>e <span class="blank _7"> </span>14 <span class="blank _7"> </span>anos <span class="blank _2"> </span>com <span class="blank _7"> </span>média <span class="blank _7"> </span>aos <span class="blank _7"> </span>12,5 <span class="blank _2"> </span>anos <span class="blank _7"> </span>e </div><div class="t m0 x1 h4 y20e ff2 fs2 fc0 sc0 ls7 ws3">se refl<span class="blank _1"> </span>ete no aumen<span class="blank _1"> </span>to da es<span class="blank _1"> </span>tatura. As adolescentes <span class="blank _1"> </span>com </div><div class="t m0 x1 h4 y20f ff2 fs2 fc0 sc0 ls7 ws3">menarca <span class="blank _c"> </span>mais <span class="blank _d"> </span>precoce <span class="blank _c"> </span>crescem <span class="blank _c"> </span>dur<span class="blank _0"></span>ante <span class="blank _c"> </span>um <span class="blank _d"> </span>maior </div><div class="t m0 x1 h4 y210 ff2 fs2 fc0 sc0 ls7 ws3">período <span class="blank"> </span>de <span class="blank"> </span>te<span class="blank _0"></span>mpo <span class="blank"> </span>na <span class="blank"> </span>fa<span class="blank _0"></span>se <span class="blank"> </span>pós-menarca. <span class="blank"> </span>A <span class="blank _3"> </span>fertilidade </div><div class="t m0 x1 h4 y211 ff2 fs2 fc0 sc0 ls7 ws3">completa <span class="blank _7"> </span>s<span class="blank _1"> </span>e <span class="blank _7"> </span>dá <span class="blank _10"> </span>2 <span class="blank _10"> </span>anos <span class="blank _7"> </span>após <span class="blank _7"> </span>a<span class="blank _1"> </span> <span class="blank _7"> </span>mesma. <span class="blank _10"> </span>O <span class="blank _10"> </span>crescimento </div><div class="t m0 x1 h4 y212 ff2 fs2 fc0 sc0 ls7 ws3">físico <span class="blank _2"> </span>e <span class="blank _2"> </span>maturação <span class="blank _2"> </span>sexual <span class="blank _2"> </span>só <span class="blank _2"> </span>se <span class="blank _2"> </span>completam <span class="blank _2"> </span>pelo <span class="blank _2"> </span>menos </div><div class="t m0 x1 h4 y213 ff2 fs2 fc0 sc0 ls7 ws3">4 <span class="blank _8"> </span>anos <span class="blank _8"> </span>depois <span class="blank _8"> </span>da <span class="blank _9"> </span>men<span class="blank _1"> </span>arca. <span class="blank _9"> </span>As <span class="blank _8"> </span>adolescentes <span class="blank _9"> </span>tê<span class="blank _1"> </span>m <span class="blank _9"> </span>alto </div><div class="t m0 x1 h4 y214 ff2 fs2 fc0 sc0 ls7 ws3">risco <span class="blank _2"> </span>obstétrico <span class="blank _2"> </span>devido <span class="blank _2"> </span>à <span class="blank _2"> </span>sua <span class="blank _2"> </span>imaturidade <span class="blank _2"> </span>biológica <span class="blank _2"> </span>para </div><div class="t m0 x1 h4 y215 ff2 fs2 fc0 sc0 ls7 ws3">atingir <span class="blank _7"> </span>o <span class="blank _7"> </span>termo. <span class="blank _7"> </span>Segundo <span class="blank _7"> </span>o <span class="blank _7"> </span>IOM<span class="blank _0"></span>, <span class="blank _7"> </span>as <span class="blank _7"> </span>de <span class="blank _7"> </span>maior <span class="blank _7"> </span>risc<span class="blank _1"> </span>o <span class="blank _7"> </span>são </div><div class="t m0 x1 h4 y216 ff2 fs2 fc0 sc0 ls7 ws3">as <span class="blank _9"> </span>adolescentes <span class="blank _9"> </span>que <span class="blank _9"> </span>têm <span class="blank _9"> </span>idade <span class="blank _9"> </span>g<span class="blank _1"> </span>inecológica <span class="blank _10"> </span>(intervalo </div><div class="t m0 x1 h4 y217 ff2 fs2 fc0 sc0 ls7 ws3">de <span class="blank _4"> </span>tempo <span class="blank _4"> </span>entre <span class="blank _4"> </span>a <span class="blank _4"> </span>mena<span class="blank _1"> </span>rca <span class="blank _a"> </span>e <span class="blank _d"> </span>a <span class="blank _4"> </span>idade <span class="blank _4"> </span>materna <span class="blank _4"> </span>na </div><div class="t m0 x1 h15 y218 ff4 fs2 fc0 sc0 ls7 ws3">concepção) m<span class="blank _1"> </span>enor que <span class="blank _1"> </span>2 a<span class="blank _1"> </span>nos e, <span class="blank _1"> </span>idade c<span class="blank _1"> </span>ronológica \u2264 <span class="blank _1"> </span>de </div><div class="t m0 x1 h4 y219 ff2 fs2 fc0 sc0 ls7 ws3">14 <span class="blank _1"> </span>anos <span class="blank _2"> </span>pois <span class="blank _1"> </span>são <span class="blank _1"> </span>anatômica <span class="blank _1"> </span>e <span class="blank _1"> </span>fis<span class="blank _1"> </span>iologicamente i<span class="blank _1"> </span>maturas </div><div class="t m0 x1 h4 y21a ff2 fs2 fc0 sc0 ls7 ws3">(Accioly). </div><div class="t m0 x3 h4 y21b ff2 fs2 fc0 sc0 ls7 ws3">Segundo <span class="blank _19"> </span>OM<span class="blank _0"></span>S <span class="blank _1d"> </span>to<span class="blank _1"> </span>das <span class="blank _19"> </span>as <span class="blank _1d"> </span>adolesce<span class="blank _1"> </span>ntes <span class="blank _1d"> </span>são </div><div class="t m0 x1 hb y21c ff2 fs2 fc0 sc0 ls7 ws3">consideradas <span class="blank _9"> </span><span class="ff3">GESTANTES <span class="blank _9"> </span>DE <span class="blank _9"> </span>RISCO</span><span class="lsb">, <span class="blank _9"> </span></span>es<span class="blank _1"> </span>pecialmente<span class="blank _0"></span> </div><div class="t m0 x1 h4 y21d ff2 fs2 fc0 sc0 ls7 ws3">as c<span class="blank _1"> </span>om idade <span class="blank _1"> </span>ginecológica < <span class="blank _1"> </span>2 <span class="blank _1"> </span>anos, as <span class="blank _1"> </span>primíparas, com </div><div class="t m0 x1 h4 y21e ff2 fs2 fc0 sc0 ls7 ws3">baixo <span class="blank _c"> </span>peso, <span class="blank _c"> </span>ou <span class="blank _c"> </span>b<span class="blank _0"></span>aixa <span class="blank _c"> </span>estatura <span class="blank _c"> </span>(Accioly<span class="blank _0"></span>). <span class="blank _12"> </span>A <span class="blank _c"> </span>mulher<span class="blank _0"></span> </div><div class="t m0 x1 h4 y21f ff2 fs2 fc0 sc0 ls7 ws3">considerada <span class="blank _7"> </span>madura <span class="blank _7"> </span>é <span class="blank _10"> </span>aquela <span class="blank _7"> </span>com <span class="blank _7"> </span>pelo <span class="blank _7"> </span>m<span class="blank _1"> </span>enos <span class="blank _10"> </span><span class="ls10">5 <span class="blank _10"> </span></span>anos </div><div class="t m0 x1 h4 y220 ff2 fs2 fc0 sc0 ls1 ws9">pós<span class="ls7 ws3">-menarca <span class="blank _7"> </span>(essa <span class="blank _7"> </span>é <span class="blank _7"> </span>a <span class="blank _7"> </span>idade <span class="blank _7"> </span>ginecológica <span class="blank _7"> </span>adequada <span class="blank _7"> </span><span class="ff4 ws7">\u2013</span> </span></div><div class="t m0 x1 h4 y221 ff2 fs2 fc0 sc0 ls7 ws3">Vitolo). <span class="blank _1a"> </span>Nos <span class="blank _1a"> </span>primeiros <span class="blank _1a"> </span>anos <span class="blank _14"> </span>a<span class="blank _1"> </span>pós <span class="blank _1a"> </span>a <span class="blank _1a"> </span>m<span class="blank _0"></span>enarca <span class="blank _1a"> </span>há </div><div class="t m0 x1 h4 y222 ff2 fs2 fc0 sc0 ls7 ws3">competição <span class="blank _17"> </span>pelos <span class="blank _13"> </span>nutrientes <span class="blank _17"> </span>entre <span class="blank _17"> </span>mãe <span class="blank _13"> </span>e <span class="blank _17"> </span>feto, </div><div class="t m0 x1 h4 y223 ff2 fs2 fc0 sc0 ls7 ws3">interferindo negativamente no resultado final (Chemin). </div><div class="t m0 x3 h4 y224 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y225 ff2 fs2 fc0 sc0 ls7 ws3">Tornam as adolescentes, gestantes de risco (Vitolo): </div><div class="t m0 x1 h4 y226 ff5 fs2 fc0 sc0 ls16">\uf0fc<span class="ff2 ls7 ws3"> <span class="blank _c"> </span>Consumo de alimentos de baixo valor nutriciona<span class="lsa">l </span> </span></div><div class="t m0 x1 h4 y227 ff5 fs2 fc0 sc0 ls16">\uf0fc<span class="ff2 ls7 ws3"> <span class="blank _c"> </span>Omissão dasprincipais refeições </span></div><div class="t m0 x1 h4 y228 ff5 fs2 fc0 sc0 ls16">\uf0fc<span class="ff2 ls7 ws3"> <span class="blank _c"> </span>Dietas restritivas </span></div><div class="t m0 x1 h4 y13d ff5 fs2 fc0 sc0 ls16">\uf0fc<span class="ff2 ls7 ws3"> <span class="blank _c"> </span>Imaturidade emocional para nova fase </span></div><div class="t m0 x3 h4 y13e ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y229 ff2 fs2 fc0 sc0 ls7 ws3">Além <span class="blank _13"> </span>da <span class="blank _13"> </span>imaturidade <span class="blank _13"> </span>biológica, <span class="blank _13"> </span>fatore<span class="blank _0"></span>s <span class="blank _13"> </span>como </div><div class="t m0 x1 h4 y22a ff2 fs2 fc0 sc0 ls7 ws3">carências <span class="blank _24"> </span>nutricionais, <span class="blank _24"> </span>tabagismo, <span class="blank _1b"> </span>instabilidade </div><div class="t m0 x1 h4 y141 ff2 fs2 fc0 sc0 ls7 ws3">emocional <span class="blank _8"> </span>e <span class="blank _8"> </span>marital <span class="blank _8"> </span>podem <span class="blank _8"> </span>determinar <span class="blank _8"> </span>o <span class="blank _8"> </span>resultado <span class="blank _8"> </span>da </div><div class="t m0 x1 h4 y142 ff2 fs2 fc0 sc0 ls7 ws3">gestação. <span class="blank _3"> </span>Mas <span class="blank _8"> </span>qu<span class="blank _1"> </span>ando <span class="blank"> </span>a <span class="blank _8"> </span>idade <span class="blank _3"> </span>ginecológica <span class="blank _3"> </span>é <span class="blank _8"> </span>meno<span class="blank _1"> </span>r </div><div class="t m0 x1 h4 y167 ff2 fs2 fc0 sc0 ls7 ws3">que <span class="blank _4"> </span>2 <span class="blank _a"> </span>anos, <span class="blank _a"> </span>a<span class="blank _1"> </span> <span class="blank _a"> </span>imaturidade <span class="blank _a"> </span>da <span class="blank _4"> </span>menina <span class="blank _a"> </span>é <span class="blank _4"> </span>que <span class="blank _a"> </span>mais </div><div class="t m0 x1 h4 y168 ff2 fs2 fc0 sc0 ls7 ws3">influência (Chemin e Vitolo). Há uma dificuldade de </div><div class="t m0 x9 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">associação <span class="blank _9"> </span>da <span class="blank _9"> </span>adolescência <span class="blank _9"> </span>com <span class="blank _9"> </span>risco <span class="blank _9"> </span>obstétrico, <span class="blank _9"> </span>pois </div><div class="t m0 x9 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3">frequentemente <span class="blank _10"> </span>há <span class="blank _10"> </span>influência <span class="blank _7"> </span>de <span class="blank _10"> </span>ou<span class="blank _1"> </span>tras <span class="blank _7"> </span>variáveis <span class="blank _10"> </span>como </div><div class="t m0 x9 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">baixo nível <span class="blank _1"> </span>s<span class="blank _1"> </span>ócio econômico, <span class="blank _1"> </span>pouca e<span class="blank _1"> </span>scolaridade, abuso </div><div class="t m0 x9 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">físico <span class="blank _a"> </span>e <span class="blank _4"> </span>psicológico, <span class="blank _a"> </span>falta <span class="blank _a"> </span>de <span class="blank _a"> </span>assistência <span class="blank _4"> </span>pré-natal <span class="blank _4"> </span>e </div><div class="t m0 x9 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">apoio social insuficiente. </div><div class="t m0 xa h4 y4c ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 xa h4 y4d ff2 fs2 fc0 sc0 ls7 ws3">Repercussões maternas: </div><div class="t m0 x9 h4 y4e ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Risco aumentado para parto cesariana e fórceps </span></div><div class="t m0 x9 h4 y4f ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span>Síndromes hipertensivas da gravidez (SHG) </span></div><div class="t m0 x9 h4 y50 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Anemia </span></div><div class="t m0 x9 h4 y51 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Risco de parto prematuro </span></div><div class="t m0 x9 h4 y52 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Disfunção uterina </span></div><div class="t m0 x9 h4 y53 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Anomalias congênitas </span></div><div class="t m0 x9 h4 y54 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls7 ws3"> <span class="blank _4"> </span> Mortalidade materna e perinatal. Neonatal (Chemin) </span></div><div class="t m0 x9 h4 y55 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Aborto (Chemin) </span></div><div class="t m0 x9 h4 y56 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y57 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y22b ff7 fs2 fc0 sc0 ls7 ws3">Accioly: <span class="ff2"> </span></div><div class="t m0 x9 h4 y59 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Complicações obstétricas e puerperais </span></div><div class="t m0 x9 h4 y5a ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Ganho de peso inadequado </span></div><div class="t m0 x9 h4 y5b ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Placenta prévia </span></div><div class="t m0 x9 h4 y5c ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">HIV </span></div><div class="t m0 x9 h4 y5d ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Fístulas </span></div><div class="t m0 x9 h4 ye6 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Retenção de peso pós-parto </span></div><div class="t m0 x9 h4 y5e ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Atraso escolar </span></div><div class="t m0 x9 h4 y5f ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Maior vulnerabilidade à violência física e abuso </span></div><div class="t m0 x9 h4 y60 ff2 fs2 fc0 sc0 ls7 ws3">sexual </div><div class="t m0 x9 h4 y61 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y62 ff2 fs2 fc0 sc0 ls7 ws3">Repercussões para o feto: </div><div class="t m0 x9 h4 ye7 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Morbidade perinatal e mortalidade infantil </span></div><div class="t m0 x9 h4 ye8 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">BPN (PN<2,5kg) </span></div><div class="t m0 x9 h4 ye9 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Muito baixo peso ao nascer (PN<1,5kg) </span></div><div class="t m0 x9 h4 yea ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Prematuridade (IG < 37semanas) </span></div><div class="t m0 x9 h4 y9e ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Retardo do crescimento intrauterino (RCIU) </span></div><div class="t m0 x9 h4 yeb ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Desproporção cefalopélvica (Chemin e Vitolo) </span></div><div class="t m0 x9 h4 yec ff2 fs2 fc0 sc0 ls7 ws3">Além disso, há aumento dos custos para o setor saúde. </div><div class="t m0 x9 h16 y22c ff7 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y22d ff7 fs2 fc0 sc0 ls7 ws3">Accioly: <span class="ff2"> </span></div><div class="t m0 x9 h4 yef ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Natimortalidade </span></div><div class="t m0 x9 h4 yf0 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Complicações neurológicas do lactente </span></div><div class="t m0 x9 h4 yf1 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Distúrbios de comportamento </span></div><div class="t m0 x9 h4 yf2 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Síndrome da atenção deficiente </span></div><div class="t m0 x9 h4 yf3 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Hiperatividade </span></div><div class="t m0 x9 h4 yf4 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Risco aumentado de abuso físico e maus tratos </span></div><div class="t m0 x9 h4 yf5 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">RN pequenos para idade gestacional (PIG) </span></div><div class="t m0 x9 h4 yf6 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Apgar baixo no 5º minuto </span></div><div class="t m0 x9 h4 yf7 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Sofrimento fetal agudo </span></div><div class="t m0 x9 h4 yf8 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 hb y1e0 ff3 fs2 fc0 sc0 ls7 ws3">Fatores que interferem no resultado obstétrico<span class="ff2"> </span></div><div class="t m0 x9 h4 y22e ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff7 ls7 ws3">Idade materna: <span class="ff2"> </span></span></div><div class="t m0 xa h4 yfb ff2 fs2 fc0 sc0 ls7 ws3">Gestantes <span class="blank _d"> </span>brancas, <span class="blank _d"> </span>mais <span class="blank _d"> </span>jovens <span class="blank _d"> </span>(< <span class="blank _d"> </span>15 <span class="blank _d"> </span>anos) <span class="blank _d"> </span>e </div><div class="t m0 x9 h4 yfc ff2 fs2 fc0 sc0 ls7 ws3">multíparas <span class="blank _10"> </span>são <span class="blank _9"> </span>as <span class="blank _10"> </span>de <span class="blank _10"> </span>maior <span class="blank _9"> </span>risco. <span class="blank _10"> </span>Quanto <span class="blank _10"> </span>mais <span class="blank _10"> </span>jo<span class="blank _1"> </span>vem,<span class="blank _0"></span> </div><div class="t m0 x9 h4 yfd ff2 fs2 fc0 sc0 ls7 ws3">maior <span class="blank _9"> </span>o <span class="blank _9"> </span>risco <span class="blank _9"> </span>de <span class="blank _9"> </span>RCIU <span class="blank _9"> </span>e<span class="blank _1"> </span> <span class="blank _9"> </span>BPN <span class="blank _10"> </span>(es<span class="blank _1"> </span>tão <span class="blank _9"> </span>associados <span class="blank _9"> </span>com </div><div class="t m0 x9 h4 yfe ff2 fs2 fc0 sc0 ls7 ws3">mortalidade <span class="blank"> </span>n<span class="blank _0"></span>eonatal), <span class="blank _8"> </span>p<span class="blank _1"> </span>or <span class="blank _8"> </span>serem<span class="blank _1"> </span> <span class="blank _8"> </span>mais <span class="blank"> </span>susceptívei<span class="blank _0"></span>s <span class="blank _8"> </span>à </div><div class="t m0 x9 h4 yff ff2 fs2 fc0 sc0 ls7 ws3">subnutrição, <span class="blank _9"> </span>já <span class="blank _9"> </span>qu<span class="blank _1"> </span>e <span class="blank _10"> </span>se<span class="blank _1"> </span> <span class="blank _9"> </span>encontram <span class="blank _8"> </span>em <span class="blank _9"> </span>rápido <span class="blank _9"> </span>processo </div><div class="t m0 x9 h4 y100 ff2 fs2 fc0 sc0 ls7 ws3">de <span class="blank"> </span>c<span class="blank _1"> </span>rescimento <span class="blank"> </span>e <span class="blank"> </span>de<span class="blank _1"> </span>senvolvimento. <span class="blank"> </span>A <span class="blank"> </span>supl<span class="blank _1"> </span>ementação </div><div class="t m0 x9 h4 y101 ff2 fs2 fc0 sc0 ls7 ws3">neste <span class="blank _1"> </span>caso <span class="blank _2"> </span>pode <span class="blank _1"> </span>ter <span class="blank _1"> </span>um <span class="blank _1"> </span>e<span class="blank _1"> </span>feito <span class="blank _1"> </span>benéfico <span class="blank _1"> </span>sobre <span class="blank _1"> </span>o <span class="blank _2"> </span>peso <span class="blank _1"> </span>do </div><div class="t m0 x9 h4 y102 ff2 fs2 fc0 sc0 ls3 ws3">bebê. </div><div class="t m0 xa h4 y103 ff2 fs2 fc0 sc0 ls7 ws3">Gestantes <span class="blank _3"> </span>de <span class="blank _8"> </span>10 <span class="blank _8"> </span>a <span class="blank _3"> </span>16 <span class="blank _8"> </span>anos <span class="blank _8"> </span>têm <span class="blank _3"> </span>crescimento <span class="blank _8"> </span>fetal </div><div class="t m0 x9 h4 y104 ff2 fs2 fc0 sc0 ls7 ws3">mais <span class="blank _12"> </span>lento <span class="blank _12"> </span>e <span class="blank _c"> </span>um<span class="blank _1"> </span>a <span class="blank _12"> </span>diminuição <span class="blank _c"> </span>no <span class="blank _12"> </span>fluxo <span class="blank _c"> </span>s<span class="blank _1"> </span>anguíneo </div><div class="t m0 x9 h4 y105 ff2 fs2 fc0 sc0 ls7 ws3">placentário, <span class="blank _8"> </span>o <span class="blank _8"> </span>que <span class="blank _8"> </span>causa <span class="blank _8"> </span>preju<span class="blank _1"> </span>ízo <span class="blank _8"> </span>no <span class="blank _9"> </span>d<span class="blank _1"> </span>esenvolvimento<span class="blank _0"></span> </div><div class="t m0 x9 h4 y106 ff2 fs2 fc0 sc0 ls7 ws3">fetal <span class="blank _7"> </span>(crescimento <span class="blank _7"> </span>mais <span class="blank _7"> </span>lento<span class="blank _1"> </span>), <span class="blank _7"> </span>isso <span class="blank _7"> </span>pode <span class="blank _7"> </span>ser <span class="blank _7"> </span>justificado </div><div class="t m0 x9 h4 y107 ff2 fs2 fc0 sc0 ls7 ws3">pela <span class="blank"> </span>hipótese <span class="blank"> </span>de <span class="blank"> </span>competição <span class="blank"> </span>entre <span class="blank"> </span>mãe <span class="blank"> </span>e <span class="blank"> </span>feto <span class="blank"> </span>pelos </div><div class="t m0 x9 h4 y108 ff2 fs2 fc0 sc0 ls7 ws3">nutrientes. </div><div class="t m0 xa h4 y109 ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _12"> </span>mãe <span class="blank _c"> </span>jovem<span class="blank _1"> </span>, <span class="blank _c"> </span>por <span class="blank _12"> </span>ser <span class="blank _c"> </span>imatu<span class="blank _1"> </span>ra, <span class="blank _c"> </span>é <span class="blank _12"> </span>incapaz <span class="blank _12"> </span>de </div><div class="t m0 x9 h4 y22f ff2 fs2 fc0 sc0 ls7 ws3">armazenar, <span class="blank _2"> </span>sob <span class="blank _1"> </span>o <span class="blank _2"> </span>estresse <span class="blank _2"> </span>físico <span class="blank _2"> </span>imposto <span class="blank _2"> </span>pela <span class="blank _2"> </span>gravidez, </div><div class="t m0 x9 h4 y230 ff2 fs2 fc0 sc0 ls7 ws3">a <span class="blank _10"> </span>mesma <span class="blank _7"> </span>quanti<span class="blank _1"> </span>dade <span class="blank _7"> </span>de <span class="blank _10"> </span>tecido <span class="blank _7"> </span>materno <span class="blank _10"> </span>e <span class="blank _10"> </span>fetal <span class="blank _7"> </span>que <span class="blank _10"> </span>as </div><div class="t m0 x9 h4 y231 ff2 fs2 fc0 sc0 ls7 ws3">gestantes <span class="blank _1"> </span>adultas, o<span class="blank _1"> </span> que<span class="blank _1"> </span> resulta <span class="blank _1"> </span>nesta <span class="blank _1"> </span>competição <span class="blank _1"> </span>pelos </div><div class="c x12 y232 wd h17"><div class="t m0 x13 h18 y233 ff3 fs8 fc0 sc0 ls7 ws3">Prof. Jamile Nogueir<span class="blank _1"> </span>a </div><div class="t m0 x14 h18 y234 ff3 fs8 fc0 sc0 ls7 ws3">jamile_n2@hotmail.com<span class="blank _1"> </span> </div><div class="t m0 x15 h18 y235 ff3 fs8 fc0 sc0 ls7 ws3"><span class="fc2 sc0"> </span></div></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf7" class="pf w0 h0" data-page-no="7"><div class="pc pc7 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x13 y236 we h19" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg7.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">292 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3">nutrientes <span class="blank _2"> </span>que<span class="blank _1"> </span> <span class="blank _2"> </span>leva <span class="blank _2"> </span>a <span class="blank _7"> </span>cetonúria <span class="blank _2"> </span>intensa <span class="blank _7"> </span>res<span class="blank _0"></span>ponsável <span class="blank _2"> </span>por </div><div class="t m0 x1 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">maior frequência de óbitos fetais e neonatais. </div><div class="t m0 x3 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h16 y237 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff7 ls7 ws3">Paridade, estado nutricional e raça: </span></div><div class="t m0 x3 h4 y4a ff2 fs2 fc0 sc0 ls7 ws3">Primíparas <span class="blank _1"> </span>de <span class="blank _1"> </span>to<span class="blank _1"> </span>das <span class="blank _1"> </span>as <span class="blank _1"> </span>idades <span class="blank _1"> </span>tendem <span class="blank _1"> </span>a <span class="blank _2"> </span>ganhar <span class="blank _1"> </span>1kg </div><div class="t m0 x1 h4 y4b ff2 fs2 fc0 sc0 ls7 ws3">a mais que as multíparas. </div><div class="t m0 x3 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">Gestantes <span class="blank _2"> </span>com <span class="blank _7"> </span>idade <span class="blank _1"> </span>ginecológica <span class="blank _7"> </span>< <span class="blank _1"> </span>2<span class="blank _1"> </span> <span class="blank _1"> </span>an<span class="blank _1"> </span>os <span class="blank _2"> </span>tendem </div><div class="t m0 x1 h4 y4d ff2 fs2 fc0 sc0 ls7 ws3">a <span class="blank _11"> </span>ganhar <span class="blank _1a"> </span>me<span class="blank _1"> </span>nos <span class="blank _1a"> </span>peso <span class="blank _11"> </span>que <span class="blank _11"> </span>gestantes <span class="blank _11"> </span>adultas <span class="blank _1a"> </span>e </div><div class="t m0 x1 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">apresentam <span class="blank _8"> </span>maior <span class="blank _8"> </span>risco <span class="blank _8"> </span>de <span class="blank _8"> </span>BPN <span class="blank _8"> </span>do <span class="blank _8"> </span>q<span class="blank _1"> </span>ue <span class="blank _8"> </span>as <span class="blank _8"> </span>gestantes </div><div class="t m0 x1 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">mais velhas com o mesmo ganho de peso gestacional. </div><div class="t m0 x3 h4 y50 ff2 fs2 fc0 sc0 ls7 ws3">Mulheres <span class="blank _12"> </span>com <span class="blank _12"> </span>IMC <span class="blank _c"> </span>p<span class="blank _1"> </span>ré-gestacional <span class="blank _12"> </span>baixo <span class="blank _12"> </span>peso, </div><div class="t m0 x1 h4 y51 ff2 fs2 fc0 sc0 ls7 ws3">mesmo <span class="blank"> </span>que <span class="blank"> </span>ganhem <span class="blank"> </span>o <span class="blank"> </span>mesmo <span class="blank"> </span>peso <span class="blank"> </span>gestacional <span class="blank"> </span>que </div><div class="t m0 x1 h4 y52 ff2 fs2 fc0 sc0 ls7 ws3">mulheres <span class="blank _10"> </span>de <span class="blank _9"> </span>outras <span class="blank _10"> </span>faixas <span class="blank _10"> </span>de <span class="blank _10"> </span>IMC, <span class="blank _10"> </span>tend<span class="blank _1"> </span>em <span class="blank _10"> </span>a <span class="blank _9"> </span>ter <span class="blank _10"> </span>filhos </div><div class="t m0 x1 h4 y53 ff2 fs2 fc0 sc0 ls7 ws3">menores. </div><div class="t m0 x3 h4 y54 ff2 fs2 fc0 sc0 ls7 ws3">Gestantes <span class="blank"> </span>negras <span class="blank _6"> </span>têm <span class="blank"> </span>fi<span class="blank _1"> </span>lhos <span class="blank"> </span>com <span class="blank"> </span>menor <span class="blank"> </span>peso <span class="blank _6"> </span>ao </div><div class="t m0 x1 h4 y55 ff2 fs2 fc0 sc0 ls7 ws3">nascer, <span class="blank _14"> </span>pois <span class="blank _14"> </span>há <span class="blank _14"> </span>associação <span class="blank _14"> </span>com <span class="blank _14"> </span>subnutrição <span class="blank _12"> </span>p<span class="blank _1"> </span>ré<span class="blank _1"> </span>-</div><div class="t m0 x1 h4 y56 ff2 fs2 fc0 sc0 ls7 ws3">gestacional e a suplementação pode ter efeito benéfico. </div><div class="t m0 x3 h4 y57 ff2 fs2 fc0 sc0 ls7 ws3">Ganho <span class="blank _2"> </span>de <span class="blank _2"> </span>peso <span class="blank _2"> </span>menor <span class="blank _1"> </span>q<span class="blank _1"> </span>ue <span class="blank _2"> </span>3,4kg <span class="blank _1"> </span>até <span class="blank _2"> </span>a <span class="blank _2"> </span>24<span class="blank _1"> </span><span class="ls18">ª <span class="blank _1"> </span></span>s<span class="blank _1"> </span>emana, </div><div class="t m0 x1 h4 y58 ff2 fs2 fc0 sc0 ls7 ws3">ou seja, inadequado, oferece aum<span class="blank _1"> </span>ento de risco para PIG </div><div class="t m0 x1 h4 y59 ff2 fs2 fc0 sc0 ls7 ws3">(pequeno <span class="blank _5"> </span>para <span class="blank _5"> </span>idade <span class="blank _6"> </span>gestacional), <span class="blank _5"> </span>mesmo <span class="blank _5"> </span>quando <span class="blank _6"> </span>o </div><div class="t m0 x1 h4 y5a ff2 fs2 fc0 sc0 ls7 ws3">ganho final de peso atinja o total recomendado. </div><div class="t m0 x3 hb y238 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y239 ff5 fs2 fc0 sc0 ls2">\uf076<span class="ff2 ls17 ws3"> <span class="ff7 ls7">Comportamento alimentar: </span></span></div><div class="t m0 x3 h4 y5d ff2 fs2 fc0 sc0 ls7 ws3">Há <span class="blank _1"> </span>tendência à<span class="blank _1"> </span> su<span class="blank _1"> </span>bstituição do <span class="blank _1"> </span>jantar <span class="blank _1"> </span>por <span class="blank _1"> </span>lanche <span class="blank _1"> </span>que </div><div class="t m0 x1 h4 ye6 ff2 fs2 fc0 sc0 ls7 ws3">favorece <span class="blank _12"> </span>o <span class="blank _c"> </span>c<span class="blank _1"> </span>onsumo <span class="blank _c"> </span>i<span class="blank _1"> </span>nadequado <span class="blank _c"> </span>ou <span class="blank _12"> </span>excessivo <span class="blank _12"> </span>de </div><div class="t m0 x1 h4 y5e ff2 fs2 fc0 sc0 ls7 ws3">energia, contribuindo para obesidade. </div><div class="t m0 x3 h4 y5f ff2 fs2 fc0 sc0 ls7 ws3">Fatores <span class="blank _21"> </span>que <span class="blank _25"> </span>contribuem <span class="blank _21"> </span>para <span class="blank _25"> </span>isso: <span class="blank _21"> </span>horários </div><div class="t m0 x1 h4 y60 ff2 fs2 fc0 sc0 ls7 ws3">irregulares, <span class="blank _7"> </span>alimentação <span class="blank _7"> </span>fora <span class="blank _2"> </span>do<span class="blank _1"> </span> <span class="blank _7"> </span>domicílio, <span class="blank _2"> </span>substi<span class="blank _1"> </span>tuições </div><div class="t m0 x1 h4 y61 ff2 fs2 fc0 sc0 ls7 ws3">por <span class="blank _5"> </span>fastfoods, <span class="blank _5"> </span>consumo <span class="blank _5"> </span>abusivo <span class="blank _5"> </span>de <span class="blank _5"> </span>álcool, <span class="blank _5"> </span>tabaco <span class="blank _5"> </span>e </div><div class="t m0 x1 h4 y62 ff2 fs2 fc0 sc0 ls7 ws3">drogas <span class="blank _1"> </span>e d<span class="blank _1"> </span>ificuldade de <span class="blank _1"> </span>relacionamento <span class="blank _1"> </span>familiar <span class="blank _1"> </span>e <span class="blank _1"> </span>baixas </div><div class="t m0 x1 h4 ye7 ff2 fs2 fc0 sc0 ls7 ws3">condições sócio econômicas. </div><div class="t m0 x3 h4 ye8 ff2 fs2 fc0 sc0 ls7 ws3">O <span class="blank _2"> </span>di<span class="blank _1"> </span>a <span class="blank _2"> </span>a <span class="blank _7"> </span>dia <span class="blank _7"> </span>agitado <span class="blank _2"> </span>pode <span class="blank _7"> </span>resultar <span class="blank _2"> </span>em <span class="blank _7"> </span>comer <span class="blank _2"> </span>fo<span class="blank _1"> </span>ra <span class="blank _2"> </span>de </div><div class="t m0 x1 h4 ye9 ff2 fs2 fc0 sc0 ls7 ws3">casa <span class="blank _9"> </span>e <span class="blank _10"> </span>esc<span class="blank _1"> </span>olher <span class="blank _10"> </span>uma <span class="blank _9"> </span>variedade <span class="blank _10"> </span>l<span class="blank _1"> </span>imitada <span class="blank _10"> </span>de <span class="blank _9"> </span>nutrientes. </div><div class="t m0 x1 h4 yea ff2 fs2 fc0 sc0 ls7 ws3">Geralmente <span class="blank _d"> </span>c<span class="blank _1"> </span>omposto <span class="blank _d"> </span>por <span class="blank _d"> </span>c<span class="blank _1"> </span>omidas <span class="blank _d"> </span>salgadas, <span class="blank _c"> </span>muit<span class="blank _0"></span>o </div><div class="t m0 x1 h4 y9e ff2 fs2 fc0 sc0 ls7 ws3">doces, <span class="blank _8"> </span>alimentos <span class="blank _9"> </span>gordurosos <span class="blank _8"> </span>e <span class="blank _9"> </span>c<span class="blank _1"> </span>om <span class="blank _9"> </span>p<span class="blank _1"> </span>oucos <span class="blank _9"> </span>nutrientes </div><div class="t m0 x1 h4 yeb ff2 fs2 fc0 sc0 ls7 ws3">(Dan). <span class="blank _8"> </span>Além <span class="blank _8"> </span>disso, <span class="blank _8"> </span>apresentam <span class="blank _8"> </span>in<span class="blank _1"> </span>gestão <span class="blank _9"> </span>excessiva <span class="blank _8"> </span>de </div><div class="t m0 x1 h4 yec ff2 fs2 fc0 sc0 ls7 ws3">sucos, <span class="blank _2"> </span>refrigerantes <span class="blank _1"> </span>e <span class="blank _1"> </span>chás, <span class="blank _2"> </span>ou <span class="blank _1"> </span>s<span class="blank _1"> </span>eja, <span class="blank _1"> </span>ingestão <span class="blank _1"> </span>e<span class="blank _1"> </span>xcessiva<span class="blank _0"></span> </div><div class="t m0 x1 h4 yed ff2 fs2 fc0 sc0 ls7 ws3">de líquidos (Vitolo). </div><div class="t m0 x3 h4 yee ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _7"> </span>dieta <span class="blank _7"> </span>ut<span class="blank _0"></span>ilizada <span class="blank _7"> </span>por <span class="blank _2"> </span>g<span class="blank _1"> </span>rupos <span class="blank _2"> </span>de <span class="blank _7"> </span>men<span class="blank _1"> </span>inas <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>15 <span class="blank _7"> </span>a <span class="blank _7"> </span>19 </div><div class="t m0 x1 h4 yef ff2 fs2 fc0 sc0 ls7 ws3">anos <span class="blank _17"> </span>de<span class="blank _1"> </span> <span class="blank _17"> </span>idade <span class="blank _17"> </span>c<span class="blank _1"> </span>ontém <span class="blank _17"> </span>frequentemente <span class="blank _16"> </span>elevada </div><div class="t m0 x1 h4 yf0 ff2 fs2 fc0 sc0 ls7 ws3">quantidade <span class="blank"> </span>de <span class="blank"> </span>gordura <span class="blank"> </span>e <span class="blank"> </span>calorias. <span class="blank"> </span>Ressalta<span class="blank _1"> </span>-se <span class="blank"> </span>que <span class="blank"> </span>a<span class="blank _0"></span> </div><div class="t m0 x1 h4 yf1 ff2 fs2 fc0 sc0 ls7 ws3">gordura <span class="blank _1"> </span>trans no <span class="blank _1"> </span>período <span class="blank _1"> </span>gestacional pode<span class="blank _1"> </span> comprometer </div><div class="t m0 x1 h4 yf2 ff2 fs2 fc0 sc0 ls7 ws3">o crescimento e o desenvolvimento fetal (Accioly). </div><div class="t m0 x7 h4 yf3 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x7 h4 yf4 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 hb y23a ff2 fs2 fc0 sc0 ls3 ws3">Inadequação <span class="blank _0"></span>de <span class="ff3 ls7">cálcio, ferro, zinco e vitamina A, </span></div><div class="t m0 x1 h4 yf6 ff2 fs2 fc0 sc0 ls7 ws3">vit B6 e ácido fólico, vit C, iodo e magnésio e menos </div><div class="t m0 x1 h4 yf7 ff2 fs2 fc0 sc0 ls7 ws3">frequente de energia, fósforo e outras vitaminas (Accioly </div><div class="t m0 x1 h4 yf8 ff2 fs2 fc0 sc0 ls7 ws3">e Chemin) X Krause: É comum iniciar a gravidez com </div><div class="t m0 x1 h4 yf9 ff2 fs2 fc0 sc0 ls7 ws3">estado nutricional abaixo do ideal, com baix<span class="blank _0"></span>o consumo </div><div class="t m0 x1 h4 yfa ff2 fs2 fc0 sc0 ls7 ws3">de ferro, cálcio e ácido fólico. </div><div class="t m0 x3 h4 yfb ff2 fs2 fc0 sc0 ls7 ws3">A refeição mais negligenciada é o desjejum, sendo </div><div class="t m0 x1 h4 yfc ff2 fs2 fc0 sc0 ls7 ws3">que 1/5 dos adolescentes não tomam café da manhã e </div><div class="t m0 x1 h4 yfd ff2 fs2 fc0 sc0 ls7 ws3">50% que realizam o fazem de maneira inadequada </div><div class="t m0 x1 h4 yfe ff2 fs2 fc0 sc0 ls7 ws3">(Dan). </div><div class="t m0 x3 h4 yff ff2 fs2 fc0 sc0 ls7 ws3">Deve-se investigar no inquérito alimentar a presença </div><div class="t m0 x1 h4 y100 ff2 fs2 fc0 sc0 ls7 ws3">de alimentos fonte de ferro, vitamina A, ácido fólico e </div><div class="t m0 x1 h4 y101 ff2 fs2 fc0 sc0 ls7 ws3">cálcio (Vitolo). </div><div class="t m0 x3 h4 y102 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x3 h4 y103 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y23b ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff7 ls7 ws3">Condições socioeconômicas:<span class="ff2"> </span></span></div><div class="t m0 x3 h4 y105 ff2 fs2 fc0 sc0 ls7 ws3">As <span class="blank _d"> </span>condições <span class="blank _d"> </span>desfavoráveis <span class="blank _d"> </span>predispõem <span class="blank _d"> </span>a <span class="blank _d"> </span>BPN, </div><div class="t m0 x1 h4 y106 ff2 fs2 fc0 sc0 ls7 ws3">complicações <span class="blank _13"> </span>n<span class="blank _1"> </span>eurológicas, <span class="blank _13"> </span>síndrome <span class="blank _17"> </span>de <span class="blank _13"> </span>atenção </div><div class="t m0 x1 h4 y107 ff2 fs2 fc0 sc0 ls7 ws3">deficiente, <span class="blank _26"> </span>hiperatividade <span class="blank _26"> </span>e <span class="blank _26"> </span>distúrbios <span class="blank _26"> </span>de<span class="blank _0"></span> </div><div class="t m0 x1 h4 y108 ff2 fs2 fc0 sc0 ls7 ws3">comportamento. <span class="blank _1"> </span>Dentre as condições socioeconômicas, </div><div class="t m0 x1 h4 y109 ff2 fs2 fc0 sc0 ls7 ws3">estão <span class="blank _14"> </span>associadas <span class="blank _12"> </span>c<span class="blank _1"> </span>om <span class="blank _14"> </span>BPN: <span class="blank _12"> </span>raç<span class="blank _1"> </span>a <span class="blank _12"> </span>(mulhere<span class="blank _1"> </span>s <span class="blank _14"> </span>não-</div><div class="t m0 x1 h4 y22f ff2 fs2 fc0 sc0 ls7 ws3">brancas), <span class="blank _c"> </span>e<span class="blank _0"></span>stado <span class="blank _d"> </span>c<span class="blank _1"> </span>ivil <span class="blank _d"> </span>(solteiras), <span class="blank _c"> </span>baix<span class="blank _0"></span>o <span class="blank _d"> </span>nível<span class="blank _1"> </span> <span class="blank _d"> </span>sóci<span class="blank _1"> </span>o<span class="blank _1"> </span>-</div><div class="t m0 x1 h4 y230 ff2 fs2 fc0 sc0 ls7 ws3">econômico e baixa escolaridade. </div><div class="t m0 x1 h4 y231 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y23c ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y23d ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff7 ls7 ws3">Infecções <span class="blank _20"> </span>g<span class="blank _0"></span>enitais:<span class="ff2"> <span class="blank _27"> </span>Doenças <span class="blank _27"> </span>sexualmente </span></span></div><div class="t m0 x9 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">transmissíveis são frequentes e podem estar associadas </div><div class="t m0 x9 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3">com BPN. </div><div class="t m0 xa h4 y49 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h16 y23e ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff7 ls7 ws3">Estresse, <span class="blank _f"> </span>pequeno <span class="blank _11"> </span>i<span class="blank _1"> </span>ntervalo <span class="blank _11"> </span>in<span class="blank _1"> </span>tergestacional <span class="blank _11"> </span>e </span></div><div class="t m0 x9 h4 y23f ff7 fs2 fc0 sc0 ls7 ws3">multiparidade: <span class="ff2">São fatores de risco para BPN. </span></div><div class="t m0 xa h4 y4c ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y4d ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Além destes, <span class="blank _1"> </span>são fatores <span class="blank _1"> </span>de ris<span class="blank _1"> </span>co para um<span class="blank _1"> </span> resultado </span></div><div class="t m0 x9 h4 y4e ff2 fs2 fc0 sc0 ls7 ws3">ruim <span class="blank _7"> </span>n<span class="blank _1"> </span>as <span class="blank _7"> </span>gestantes <span class="blank _10"> </span>adolescentes: <span class="blank _10"> </span>anemia <span class="blank _10"> </span>preexistente, </div><div class="t m0 x9 h4 y4f ff2 fs2 fc0 sc0 ls7 ws3">abuso <span class="blank _9"> </span>de <span class="blank _10"> </span>certas <span class="blank _9"> </span>substâncias: <span class="blank _10"> </span>fu<span class="blank _1"> </span>mo, <span class="blank _10"> </span>bebidas <span class="blank _9"> </span>e <span class="blank _9"> </span>drogas, </div><div class="t m0 x9 h4 y50 ff2 fs2 fc0 sc0 ls7 ws3">falta <span class="blank _d"> </span>de <span class="blank _d"> </span>apoio <span class="blank _d"> </span>social <span class="blank _4"> </span>e <span class="blank _d"> </span>de <span class="blank _d"> </span>educação, <span class="blank _d"> </span>ausência <span class="blank _d"> </span>ou </div><div class="t m0 x9 h4 y51 ff2 fs2 fc0 sc0 ls1">en<span class="ls7 ws3">trada <span class="blank _7"> </span>ta<span class="blank _1"> </span>rdia <span class="blank _7"> </span>no <span class="blank _10"> </span>sistema <span class="blank _10"> </span>de <span class="blank _10"> </span>cuidado <span class="blank _10"> </span>de <span class="blank _10"> </span>saúde <span class="blank _7"> </span>e <span class="blank _10"> </span>falta </span></div><div class="t m0 x9 h4 y52 ff2 fs2 fc0 sc0 ls7 ws3">de assistência pré-natal apropriada a idade (Krause). </div><div class="t m0 x9 h4 y53 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 hb y240 ff3 fs2 fc0 sc0 ls7 ws3">Assistência pré-natal: </div><div class="t m0 x9 h4 y55 ff2 fs2 fc0 sc0 ls7 ws3">Objetivos da assistência ao pré-natal (Accioly): </div><div class="t m0 x9 h4 y56 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y57 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Promoção do ganho de peso gestacional adequado </span></div><div class="t m0 x9 h4 y58 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Prevenção de complicações obstétricas maternas </span></div><div class="t m0 x9 h4 y59 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Redução nas taxas de BPN, RNPT e natimortos </span></div><div class="t m0 x9 h4 y5a ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Prevenção de gestações repetidas e indesejáveis </span></div><div class="t m0 x9 h4 y5b ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Redução da mortalidade materna </span></div><div class="t m0 x9 h4 y5c ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff2 ls7 ws3">Prevenção do aborto ilegal </span></div><div class="t m0 x9 h4 y5d ff2 fs2 fc0 sc0 ls4 ws3"> <span class="ls7 v2">Deve-se <span class="blank _24"> </span>te<span class="blank _1"> </span>r <span class="blank _24"> </span>a <span class="blank _24"> </span>participação <span class="blank _24"> </span>de <span class="blank _28"> </span>equipe </span></div><div class="t m0 x9 h4 y5e ff2 fs2 fc0 sc0 ls7 ws3">multiprofissional <span class="blank _c"> </span>e<span class="blank _1"> </span> <span class="blank _c"> </span>in<span class="blank _1"> </span>terdisciplinar. <span class="blank _12"> </span>A <span class="blank _c"> </span>assistência <span class="blank _12"> </span>do </div><div class="t m0 x9 h4 y5f ff2 fs2 fc0 sc0 ls7 ws3">nutricionista <span class="blank _16"> </span>é <span class="blank _16"> </span>indispensável <span class="blank _16"> </span>nos <span class="blank _16"> </span>programas <span class="blank _16"> </span>de </div><div class="t m0 x9 h4 y60 ff2 fs2 fc0 sc0 ls7 ws3">assistência às gestantes adolescentes (Accioly). </div><div class="t m0 xa h4 y61 ff2 fs2 fc0 sc0 ls7 ws3">Em <span class="blank _14"> </span>geral, <span class="blank _12"> </span>a <span class="blank _14"> </span>ass<span class="blank _1"> </span>istência <span class="blank _12"> </span>pré<span class="blank _1"> </span>-natal <span class="blank _12"> </span>é <span class="blank _14"> </span>procurada </div><div class="t m0 x9 h4 y62 ff2 fs2 fc0 sc0 ls7 ws3">tardiamente <span class="blank _d"> </span>devido <span class="blank _c"> </span>à <span class="blank _d"> </span>dificuldade <span class="blank _d"> </span>de <span class="blank _d"> </span>reconhecer <span class="blank _d"> </span>os </div><div class="t m0 x9 h4 ye7 ff2 fs2 fc0 sc0 ls7 ws3">sinais <span class="blank _6"> </span>e <span class="blank _6"> </span>sintomas <span class="blank _6"> </span>e <span class="blank _5"> </span>por <span class="blank _6"> </span>não <span class="blank _6"> </span>quererem <span class="blank _5"> </span>a <span class="blank _6"> </span>quebra <span class="blank _6"> </span>da </div><div class="t m0 x9 h4 ye8 ff2 fs2 fc0 sc0 ls7 ws3">confidencialidade, <span class="blank _17"> </span>piorando <span class="blank _17"> </span>as <span class="blank _17"> </span>consequências <span class="blank _17"> </span>da </div><div class="t m0 x9 h4 ye9 ff2 fs2 fc0 sc0 ls7 ws3">gravidez. </div><div class="t m0 xa h4 yea ff2 fs2 fc0 sc0 ls7 ws3">São <span class="blank _a"> </span>cole<span class="blank _1"> </span>tados: <span class="blank _a"> </span>idade <span class="blank _a"> </span>cronológica <span class="blank _4"> </span>e <span class="blank _a"> </span>ginecológica, </div><div class="t m0 x9 h4 y9e ff2 fs2 fc0 sc0 ls7 ws3">estado <span class="blank _1a"> </span>nutricional <span class="blank _14"> </span>pré<span class="blank _1"> </span>-gestacional, <span class="blank _1a"> </span>ganho <span class="blank _14"> </span>de <span class="blank _1a"> </span>peso </div><div class="t m0 x9 h4 yeb ff2 fs2 fc0 sc0 ls7 ws3">gestacional, <span class="blank _d"> </span>sinais <span class="blank _c"> </span>clíni<span class="blank _0"></span>cos <span class="blank _d"> </span>de <span class="blank _c"> </span>má <span class="blank _d"> </span>nutrição, <span class="blank _d"> </span>índices </div><div class="t m0 x9 h4 yec ff2 fs2 fc0 sc0 ls7 ws3">hematológicos, <span class="blank _9"> </span>atividade <span class="blank _9"> </span>física, <span class="blank _8"> </span>uso <span class="blank _9"> </span>de <span class="blank _9"> </span>m<span class="blank _1"> </span>edicamentos, </div><div class="t m0 x9 h4 yed ff2 fs2 fc0 sc0 ls7 ws3">presença <span class="blank _10"> </span>de <span class="blank _10"> </span>doenças <span class="blank _10"> </span>c<span class="blank _1"> </span>rônicas <span class="blank _10"> </span>ou <span class="blank _10"> </span>infecções, <span class="blank _10"> </span>avaliação </div><div class="t m0 x9 h4 yee ff2 fs2 fc0 sc0 ls7 ws3">dietética <span class="blank _9"> </span>c<span class="blank _1"> </span>om <span class="blank _9"> </span>ênfase <span class="blank _8"> </span>na <span class="blank _8"> </span>ingestão <span class="blank _8"> </span>de <span class="blank _8"> </span>proteínas, <span class="blank _9"> </span>fibras, </div><div class="t m0 x9 h4 yef ff2 fs2 fc0 sc0 ls7 ws3">vitamina C, cálcio, ferro, calorias vazias e gordura. </div><div class="t m0 x9 h1a y241 ff5 fs6 fc0 sc0 ls7">\uf020</div><div class="t m0 x9 h16 y242 ff5 fs2 fc0 sc0 ls2 wsd">\uf076\uf020<span class="ff7 ls7 ws3">Avaliação antropométrica: </span></div><div class="t m0 xa h4 y243 ff2 fs2 fc0 sc0 ls7 ws3">Em <span class="blank"> </span>torno <span class="blank _6"> </span>de <span class="blank"> </span>50% <span class="blank _6"> </span>das <span class="blank"> </span>adolescentes <span class="blank"> </span>mantêm <span class="blank"> </span>seu </div><div class="t m0 x9 h4 y244 ff2 fs2 fc0 sc0 ls7 ws3">crescimento durante a <span class="blank _1"> </span>gestação, embora seja mais lento </div><div class="t m0 x9 h4 y245 ff2 fs2 fc0 sc0 ls7 ws3">do <span class="blank _9"> </span>que <span class="blank _9"> </span>se <span class="blank _9"> </span>elas <span class="blank _9"> </span>não <span class="blank _9"> </span>estivessem <span class="blank _9"> </span>grávidas, <span class="blank _9"> </span>promovendo </div><div class="t m0 x9 h4 y246 ff2 fs2 fc0 sc0 ls7 ws3">competição <span class="blank _17"> </span>pelos <span class="blank _17"> </span>nutrientes <span class="blank _17"> </span>ou <span class="blank _17"> </span>imaturidade <span class="blank _17"> </span>em </div><div class="t m0 x9 h4 y247 ff2 fs2 fc0 sc0 ls7 ws3">transferí-los <span class="blank _9"> </span>para <span class="blank _9"> </span>o <span class="blank _9"> </span>feto, <span class="blank _9"> </span>gerando <span class="blank _9"> </span>conceptos <span class="blank _9"> </span>de <span class="blank _9"> </span>menor </div><div class="t m0 x9 h4 y248 ff2 fs2 fc0 sc0 ls7 ws3">peso. As <span class="blank _1"> </span>outras 50% <span class="blank _1"> </span>das adolescentes interrompem s<span class="blank _2"> </span><span class="ls10">eu </span></div><div class="t m0 x9 h4 y249 ff2 fs2 fc0 sc0 ls7 ws3">crescimento <span class="blank"> </span>linear <span class="blank"> </span>comprometendo <span class="blank"> </span>sua <span class="blank"> </span>estatura <span class="blank"> </span>final, </div><div class="t m0 x9 h4 y24a ff2 fs2 fc0 sc0 ls7 ws3">segundo <span class="blank _2"> </span>alguns <span class="blank _2"> </span>autores, <span class="blank _2"> </span>esta <span class="blank _2"> </span>deve <span class="blank _2"> </span>ser <span class="blank _2"> </span>mensurada <span class="blank _2"> </span>pela </div><div class="t m0 x9 h4 y24b ff2 fs2 fc0 sc0 ls7 ws3">altura do joelho. </div><div class="t m0 xa h4 y24c ff2 fs2 fc0 sc0 ls7 ws3">Algumas <span class="blank _12"> </span>gestantes <span class="blank _12"> </span>adolescentes <span class="blank _c"> </span>continuam <span class="blank _12"> </span>seu </div><div class="t m0 x9 h4 y24d ff2 fs2 fc0 sc0 ls7 ws3">crescimento <span class="blank _14"> </span>durante <span class="blank _12"> </span>a <span class="blank _14"> </span>gestação, <span class="blank _14"> </span>neste <span class="blank _14"> </span>caso <span class="blank _14"> </span>elas </div><div class="t m0 x9 h4 y24e ff2 fs2 fc0 sc0 ls7 ws3">tendem <span class="blank _1"> </span>a <span class="blank _1"> </span>ganhar <span class="blank _1"> </span>mais <span class="blank _1"> </span>peso<span class="blank _1"> </span> e <span class="blank _1"> </span>manter <span class="blank _2"> </span>este <span class="blank _1"> </span>peso, <span class="blank _1"> </span>após <span class="blank _1"> </span>o </div><div class="t m0 x9 h4 y24f ff2 fs2 fc0 sc0 ls7 ws3">parto, <span class="blank _d"> </span>além <span class="blank _c"> </span>de <span class="blank _d"> </span>terem <span class="blank _d"> </span>recém-nascidos <span class="blank _c"> </span>menores <span class="blank _4"> </span>e<span class="blank _1"> </span>m </div><div class="t m0 x9 h4 yb1 ff2 fs2 fc0 sc0 ls7 ws3">crescimento (Dan). </div><div class="t m0 xa h4 y250 ff2 fs2 fc0 sc0 ls7 ws3">Quanto <span class="blank _25"> </span>mais <span class="blank _21"> </span>j<span class="blank _1"> </span>ovem <span class="blank _21"> </span>fo<span class="blank _1"> </span>r <span class="blank _21"> </span>a <span class="blank _25"> </span>gestante, <span class="blank _25"> </span>maior </div><div class="t m0 x9 h4 y251 ff2 fs2 fc0 sc0 ls7 ws3">probabilidade <span class="blank _a"> </span>de<span class="blank _1"> </span> <span class="blank _a"> </span>manter <span class="blank _a"> </span>s<span class="blank _1"> </span>eu <span class="blank _a"> </span>crescimento <span class="blank _4"> </span>durante <span class="blank _a"> </span>a </div><div class="t m0 x9 h4 y252 ff2 fs2 fc0 sc0 ls7 ws3">gravidez, <span class="blank _17"> </span>portanto, <span class="blank _17"> </span>maior<span class="blank _0"></span> <span class="blank _17"> </span>será <span class="blank _17"> </span>sua <span class="blank _17"> </span>nec<span class="blank _0"></span>essidade </div><div class="t m0 x9 h4 y253 ff2 fs2 fc0 sc0 ls7 ws3">energética (Dan). </div><div class="t m0 xa h4 y254 ff2 fs2 fc0 sc0 ls7 ws3">O <span class="blank _5"> </span>Ministério <span class="blank _5"> </span>da <span class="blank _5"> </span>Saúde <span class="blank _5"> </span>preconiza <span class="blank _5"> </span>a <span class="blank _5"> </span>avaliação <span class="blank _5"> </span>do </div><div class="t m0 x9 h4 y255 ff2 fs2 fc0 sc0 ls7 ws3">estado <span class="blank _9"> </span>nutricional <span class="blank _9"> </span>de <span class="blank _9"> </span>todas <span class="blank _9"> </span>as <span class="blank _9"> </span>g<span class="blank _1"> </span>estantes <span class="blank _10"> </span>adolescentes </div><div class="t m0 x9 h4 y162 ff2 fs2 fc0 sc0 ls1 ws3">na <span class="blank _1"> </span><span class="ls7">ro<span class="blank _1"> </span>tina <span class="blank _1"> </span>da <span class="blank _2"> </span>Assistência <span class="blank _2"> </span>Pré-natal <span class="blank _2"> </span>por <span class="blank _2"> </span>meio <span class="blank _1"> </span>da <span class="blank _2"> </span>proposta </span></div><div class="t m0 x9 h4 y256 ff2 fs2 fc0 sc0 ls7 ws3">metodológica <span class="blank _1"> </span>com base<span class="blank _1"> </span> nas <span class="blank _1"> </span>recomendações <span class="blank _1"> </span><span class="ff7">do <span class="blank _1"> </span>Institute </span></div><div class="t m0 x9 h4 y257 ff7 fs2 fc0 sc0 ls7 ws3">of Medicine<span class="ff2"> (IOM), da OMS e do estudo de </span><span class="ws7">Atalah</span><span class="ff2 lsb">. <span class="ls7"> </span></span></div><div class="t m0 xa h4 y258 ff2 fs2 fc0 sc0 ls7 ws3">Em <span class="blank _4"> </span>2009, <span class="blank _4"> </span>o <span class="blank _4"> </span>IOM <span class="blank _4"> </span>publicou <span class="blank _4"> </span>uma <span class="blank _4"> </span>atualização <span class="blank _4"> </span>das </div><div class="t m0 x9 h4 y259 ff2 fs2 fc0 sc0 ls7 ws3">recomendações para ganho de pe<span class="blank _1"> </span>so durante a gestação </div><div class="t m0 x9 h4 y25a ff2 fs2 fc0 sc0 ls7 ws3">a <span class="blank _8"> </span>serem <span class="blank _8"> </span>aplicadas <span class="blank _8"> </span>a <span class="blank _8"> </span>mulheres <span class="blank _8"> </span>americanas. <span class="blank _8"> </span>Dentre <span class="blank _8"> </span>as </div><div class="t m0 x9 h4 y25b ff2 fs2 fc0 sc0 ls7 ws3">alterações <span class="blank _c"> </span>observadas <span class="blank _c"> </span>na <span class="blank _d"> </span>nova <span class="blank _c"> </span>recomendação, <span class="blank _c"> </span>em </div><div class="t m0 x9 h4 y25c ff2 fs2 fc0 sc0 ls7 ws3">comparação <span class="blank _2"> </span>àquelas <span class="blank _7"> </span>p<span class="blank _0"></span>ublicadas <span class="blank _2"> </span>em <span class="blank _2"> </span>1990, <span class="blank _2"> </span>d<span class="blank _1"> </span>estacam-se </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf8" class="pf w0 h0" data-page-no="8"><div class="pc pc8 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1 y25d wf h1b" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg8.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">293 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y86 ff2 fs2 fc0 sc0 ls7 ws3">os <span class="blank _5"> </span><span class="ff3">pontos <span class="blank _5"> </span>de <span class="blank _5"> </span>corte <span class="blank _5"> </span>da <span class="blank _5"> </span>OMS</span>, <span class="blank _5"> </span>para<span class="blank _1"> </span> <span class="blank _6"> </span>a <span class="blank _5"> </span>avaliação <span class="blank _5"> </span>de </div><div class="t m0 x1 h4 y5 ff2 fs2 fc0 sc0 ls7 ws3">mulheres adultas e adolescentes. </div><div class="t m0 x3 h4 y48 ff2 fs2 fc0 sc0 ls7 ws3">Accioly <span class="blank _d"> </span>recomenda <span class="blank _d"> </span>avaliar <span class="blank _d"> </span>as <span class="blank _d"> </span>adolescentes <span class="blank _d"> </span>com </div><div class="t m0 x1 h4 y49 ff2 fs2 fc0 sc0 ls7 ws3">base <span class="blank _f"> </span>na <span class="blank _11"> </span>cl<span class="blank _1"> </span>assificação <span class="blank _11"> </span>do <span class="blank _11"> </span>esta<span class="blank _1"> </span>do <span class="blank _11"> </span>nutricional <span class="blank _f"> </span>pré<span class="blank _1"> </span>-</div><div class="t m0 x1 hb y25e ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank"> </span>ba<span class="blank _0"></span>seada <span class="blank"> </span>nas<span class="blank _0"></span> <span class="blank"> </span>cur<span class="blank _0"></span>vas <span class="blank"> </span>prop<span class="blank _0"></span>ostas <span class="blank _3"> </span>pela <span class="blank"> </span><span class="ff3">OMS </span></div><div class="t m0 x1 hb y25f ff3 fs2 fc0 sc0 ls3 ws3">2006/20007,<span class="blank _0"></span> <span class="ff2 ls7">c<span class="blank _1"> </span>om base <span class="blank _1"> </span>na <span class="blank _1"> </span>idade (a<span class="blank _1"> </span>nos e m<span class="blank _1"> </span>eses) e<span class="blank _1"> </span> sexo. </span></div><div class="t m0 x1 h4 y4c ff2 fs2 fc0 sc0 ls7 ws3">Deve <span class="blank _7"> </span>ser <span class="blank _7"> </span>empregada <span class="blank _7"> </span>quando <span class="blank _7"> </span>peso <span class="blank _7"> </span>pré<span class="blank _1"> </span> <span class="blank _7"> </span>é <span class="blank _7"> </span>conhecido <span class="blank _7"> </span>ou </div><div class="t m0 x1 hb y260 ff2 fs2 fc0 sc0 ls7 ws3">aferido <span class="blank _11"> </span>até <span class="blank _11"> </span>a <span class="blank _11"> </span><span class="ff3">13ª <span class="blank _11"> </span>semana <span class="blank _11"> </span>gestacional <span class="blank _1a"> </span>x <span class="blank _f"> </span>peso </span></div><div class="t m0 x1 hb y261 ff3 fs2 fc0 sc0 ls7 ws3">mensurado <span class="blank _a"> </span>até <span class="blank _5"> </span>2 <span class="blank _a"> </span>meses <span class="blank _5"> </span>antes <span class="blank _a"> </span>da <span class="blank _a"> </span>concepção <span class="blank _5"> </span>ou </div><div class="t m0 x1 hb y262 ff3 fs2 fc0 sc0 ls7 ws3">aferido <span class="blank _1"> </span>a<span class="blank _1"> </span>té <span class="blank _1"> </span>a <span class="blank _1"> </span>14ª <span class="blank _1"> </span>semana <span class="blank _1"> </span>gestac<span class="blank _1"> </span>ional <span class="blank _1"> </span>(Accioly)<span class="ff2">. <span class="blank _2"> </span>Caso </span></div><div class="t m0 x1 h4 y50 ff2 fs2 fc0 sc0 ls7 ws3">o <span class="blank _a"> </span>pe<span class="blank _1"> </span>so <span class="blank _a"> </span>pré <span class="blank _4"> </span>ou <span class="blank _a"> </span>até <span class="blank _4"> </span>a <span class="blank _a"> </span>13ª <span class="blank _4"> </span>semana <span class="blank _a"> </span>gestacional<span class="blank _1"> </span> <span class="blank _a"> </span>seja </div><div class="t m0 x1 h4 y51 ff2 fs2 fc0 sc0 ls7 ws3">desconhecido, utiliza-se a proposta de Atalah. </div><div class="t m0 x3 h4 y52 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y263 ff3 fs2 fc0 sc0 ls7 ws3">Procedimentos <span class="blank _1d"> </span>para <span class="blank _19"> </span>avaliação <span class="blank _19"> </span>antropométrica<span class="ff2 ls12">: </span></div><div class="t m0 x1 h4 y54 ff2 fs2 fc0 sc0 ls7 ws3">Inicialmente <span class="blank"> </span>deve-se <span class="blank"> </span>obter <span class="blank"> </span>o <span class="blank"> </span>peso <span class="blank"> </span>pré<span class="blank _1"> </span>-gestacional <span class="blank"> </span>ou<span class="blank _0"></span> </div><div class="t m0 x1 h4 y55 ff2 fs2 fc0 sc0 ls7 ws3">inicial, peso atual, estatura materna e idade gestacional. </div><div class="t m0 x1 h4 y56 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y264 ff2 fs2 fc0 sc0 ls1 ws9">a)<span class="ls17 ws3"> <span class="ff3 ls7">Peso <span class="blank _1"> </span>pré<span class="blank _1"> </span>-gestacional <span class="blank _1"> </span>conhecido</span><span class="ls19"> <span class="ff5 ls7 ws2">\uf0e0</span><span class="ls7"> <span class="blank _2"> </span>calcular <span class="blank _1"> </span>o <span class="blank _2"> </span>IMC </span></span></span></div><div class="t m0 x1 h4 y58 ff2 fs2 fc0 sc0 ls7 ws3">pré-gestacional <span class="blank _13"> </span>e <span class="blank _13"> </span><span class="ls1d wse">co<span class="blank _1"> </span></span>nsultar <span class="blank _e"> </span>o<span class="blank _1"> </span>s <span class="blank _13"> </span>pontos <span class="blank _13"> </span>de <span class="blank _13"> </span>corte </div><div class="t m0 x1 h4 y59 ff2 fs2 fc0 sc0 ls7 ws3">específicos <span class="blank _1"> </span>segundo <span class="blank _1"> </span>a <span class="blank _1"> </span>idade <span class="blank _1"> </span>materna <span class="blank _1"> </span>de <span class="blank _1"> </span>acordo <span class="blank _1"> </span>com <span class="blank _1"> </span>as </div><div class="t m0 x1 h4 y5a ff2 fs2 fc0 sc0 ls7 ws3">curvas <span class="blank _9"> </span>da <span class="blank _8"> </span>OMS <span class="blank _10"> </span>(2<span class="blank _1"> </span>006/2007, <span class="blank _9"> </span>qua<span class="blank _1"> </span>dro <span class="blank _9"> </span>2) <span class="blank _9"> </span>e <span class="blank _9"> </span>c<span class="blank _1"> </span>lassificá-los </div><div class="t m0 x1 h4 y5b ff2 fs2 fc0 sc0 ls7 ws3">de <span class="blank _7"> </span>acordo <span class="blank _10"> </span>com <span class="blank _7"> </span>o <span class="blank _7"> </span>quadro <span class="blank _7"> </span>abaixo <span class="blank _10"> </span>(quadro <span class="blank _7"> </span>1<span class="blank _1"> </span>). <span class="blank _7"> </span>Calcular <span class="blank _7"> </span>o </div><div class="t m0 x1 h4 y5c ff2 fs2 fc0 sc0 ls7 ws3">ganho <span class="blank _9"> </span>de <span class="blank _8"> </span>peso <span class="blank _9"> </span>seman<span class="blank _1"> </span>al <span class="blank _9"> </span>e <span class="blank _9"> </span>total <span class="blank _8"> </span>baseado <span class="blank _9"> </span>no <span class="blank _8"> </span>quadro <span class="blank _9"> </span>4 </div><div class="t m0 x1 h4 y5d ff2 fs2 fc0 sc0 ls7 ws3">(IOM, 2009): </div><div class="t m0 x1 hb y265 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y266 ff3 fs2 fc0 sc0 ls7 ws3">Quadro 1: </div><div class="t m0 x1 hb y267 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y268 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y269 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y26a ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y26b ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y26c ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y26d ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y26e ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y26f ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y270 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y271 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y272 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y273 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y274 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y275 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y276 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y277 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y278 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y279 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y23a ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y27a ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y27b ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y1df ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y1e0 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y27c ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y27d ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y27e ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y27f ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y280 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y281 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y282 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y283 ff3 fs2 fc0 sc0 ls2 wsf">b)<span class="ls7 ws3"> <span class="blank _5"> </span>Peso <span class="blank _3"> </span>pré-gestacional <span class="blank _3"> </span>desconhecido <span class="blank _8"> </span>e <span class="blank _3"> </span>avaliação </span></div><div class="t m0 x1 hb y284 ff3 fs2 fc0 sc0 ls7 ws3">com <span class="blank _7"> </span>base <span class="blank _2"> </span>no <span class="blank _7"> </span>I<span class="blank _0"></span>MC <span class="blank _7"> </span>gest<span class="blank _0"></span>acional <span class="blank _7"> </span><span class="ff5 sc1 ls1a">\uf0e0</span><span class="ls1b"> </span><span class="ff2">C<span class="blank _0"></span>aso <span class="blank _7"> </span>o <span class="blank _2"> </span>peso <span class="blank _2"> </span>p<span class="blank _1"> </span>ré <span class="blank _2"> </span>ou </span></div><div class="t m0 x1 h4 y103 ff2 fs2 fc0 sc0 ls7 ws3">até a 14ª semana gestacional seja desconhecido, utiliza<span class="blank _1"> </span>-</div><div class="t m0 x1 hb y104 ff2 fs2 fc0 sc0 ls7 ws3">se a proposta de Atalah. <span class="ff3"> </span></div><div class="t m0 x3 h4 y105 ff2 fs2 fc0 sc0 ls7 ws3"> Utilizar <span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _1"> </span>peso <span class="blank _1"> </span>da <span class="blank _1"> </span>c<span class="blank _1"> </span>onsulta <span class="blank _1"> </span>e <span class="blank _1"> </span>realizar <span class="blank _2"> </span>a <span class="blank _1"> </span>c<span class="blank _1"> </span>lassificação </div><div class="t m0 x1 h4 y106 ff2 fs2 fc0 sc0 ls7 ws3">pelo quadro 3. </div><div class="t m0 x1 h4 y107 ff2 fs2 fc0 sc0 ls7 ws3">O <span class="blank _8"> </span>Ministério <span class="blank _9"> </span>da <span class="blank _8"> </span>Saúde <span class="blank _8"> </span>ressalta <span class="blank _9"> </span>q<span class="blank _1"> </span>ue <span class="blank _9"> </span>o <span class="blank _8"> </span>método <span class="blank _9"> </span>não <span class="blank _8"> </span>foi </div><div class="t m0 x1 h4 y108 ff2 fs2 fc0 sc0 ls7 ws3">proposto <span class="blank _7"> </span>para <span class="blank _2"> </span>g<span class="blank _1"> </span>estantes <span class="blank _2"> </span>adolescentes. <span class="blank _7"> </span>No <span class="blank _7"> </span>entanto <span class="blank _2"> </span>esta </div><div class="t m0 x1 h4 y109 ff2 fs2 fc0 sc0 ls7 ws3">classificação <span class="blank _2"> </span>pode <span class="blank _1"> </span>s<span class="blank _1"> </span>er <span class="blank _1"> </span>usada <span class="blank _1"> </span>de<span class="blank _1"> </span>sde <span class="blank _1"> </span>que <span class="blank _2"> </span>a <span class="blank _2"> </span>interpretação </div><div class="t m0 x1 h4 y22f ff2 fs2 fc0 sc0 ls7 ws3">seja <span class="blank _10"> </span>flexível. <span class="blank _9"> </span>Assim, <span class="blank _10"> </span>considerar: <span class="blank _10"> </span>a<span class="blank _1"> </span> <span class="blank _10"> </span>avaliação <span class="blank _10"> </span>inical <span class="blank _10"> </span>com </div><div class="t m0 x1 h4 y230 ff2 fs2 fc0 sc0 ls7 ws3">base <span class="blank _1"> </span>no <span class="blank _1"> </span>IMC <span class="blank _1"> </span>gestacional, <span class="blank _2"> </span>pela <span class="blank _1"> </span>tabela <span class="blank _1"> </span>ou <span class="blank _1"> </span>gráfico <span class="blank _1"> </span>(quadro </div><div class="t m0 x1 h4 y231 ff2 fs2 fc0 sc0 ls7 ws3">3 ou figura 1). </div><div class="t m0 x3 h4 y23c ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 xa h4 y4 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y285 ff8 fs2 fc0 sc0 ls7 ws2">\uf0b7<span class="ff2 ws3"> <span class="blank _17"> </span>Para <span class="blank _1"> </span>a<span class="blank _1"> </span>dolescentes <span class="blank _1"> </span>que <span class="blank _1"> </span>en<span class="blank _1"> </span>gravidaram <span class="blank _1"> </span>2 <span class="blank _2"> </span>anos <span class="blank _1"> </span>a<span class="blank _1"> </span>pós <span class="blank _1"> </span>a </span></div><div class="t m0 x9 h4 y286 ff2 fs2 fc0 sc0 ls7 ws3">menarca, <span class="blank _12"> </span>a <span class="blank _c"> </span>interpretação <span class="blank _c"> </span>pode <span class="blank _12"> </span>ser <span class="blank _12"> </span>equivalente <span class="blank _c"> </span>às </div><div class="t m0 x9 h4 y287 ff2 fs2 fc0 sc0 ls7 ws3">adultas; </div><div class="t m0 x9 h4 y288 ff8 fs2 fc0 sc0 ls7 ws2">\uf0b7<span class="ff2 ws3"> <span class="blank _17"> </span>Para <span class="blank _8"> </span>as <span class="blank _8"> </span>que <span class="blank _9"> </span>engra<span class="blank _1"> </span>vidaram <span class="blank _9"> </span>menos <span class="blank _8"> </span>de <span class="blank _9"> </span>2<span class="blank _1"> </span> <span class="blank _9"> </span>anos <span class="blank _8"> </span>pós<span class="blank _1"> </span>-</span></div><div class="t m0 x9 h4 y289 ff2 fs2 fc0 sc0 ls7 ws3">menarca é<span class="blank _1"> </span> provável <span class="blank _1"> </span>que sejam <span class="blank _1"> </span>classificad<span class="blank _1"> </span>as como <span class="blank _1"> </span>baixo </div><div class="t m0 x9 h4 y28a ff2 fs2 fc0 sc0 ls7 ws3">peso. <span class="blank"> </span>Devem <span class="blank"> </span>ter <span class="blank _3"> </span>a <span class="blank"> </span>e<span class="blank _0"></span>statura <span class="blank"> </span>mensurada <span class="blank _3"> </span>em <span class="blank"> </span>todas <span class="blank"> </span>a<span class="blank _0"></span>s </div><div class="t m0 x9 h4 y28b ff2 fs2 fc0 sc0 ls7 ws3">consultas. <span class="blank _7"> </span>Deve-se <span class="blank _7"> </span>acompanhar <span class="blank _7"> </span>o <span class="blank _7"> </span>traç<span class="blank _1"> </span>ado <span class="blank _7"> </span>da <span class="blank _7"> </span>curva <span class="blank _7"> </span>de </div><div class="t m0 x9 h4 y28c ff2 fs2 fc0 sc0 ls7 ws3">IMC, que deve ser ascendente. </div><div class="t m0 x9 h4 y28d ff8 fs2 fc0 sc0 ls7 ws2">\uf0b7<span class="ff2 ws3"> <span class="blank _17"> </span>A <span class="blank _8"> </span>utilização <span class="blank _8"> </span>do<span class="blank _1"> </span> <span class="blank _9"> </span>grá<span class="blank _1"> </span>fico <span class="blank _8"> </span>de <span class="blank _8"> </span>evolução <span class="blank _8"> </span>d<span class="blank _1"> </span>o <span class="blank _8"> </span>traçado <span class="blank _8"> </span>de </span></div><div class="t m0 x9 h4 y28e ff2 fs2 fc0 sc0 ls7 ws3">IMC <span class="blank _7"> </span>ges<span class="blank _1"> </span>tacional <span class="blank _10"> </span>proposto <span class="blank _10"> </span>pelo <span class="blank _10"> </span>MS <span class="blank _10"> </span>para <span class="blank _9"> </span>adultas, <span class="blank _10"> </span>como </div><div class="t m0 x9 h4 y28f ff2 fs2 fc0 sc0 ls7 ws3">dito <span class="blank _9"> </span>anteriormente, <span class="blank _10"> </span>de<span class="blank _1"> </span>ve <span class="blank _10"> </span>ser <span class="blank _10"> </span>ado<span class="blank _1"> </span>tado <span class="blank _10"> </span>para <span class="blank _9"> </span>a <span class="blank _9"> </span>avaliação </div><div class="t m0 x9 h4 y290 ff2 fs2 fc0 sc0 ls7 ws3">das <span class="blank _e"> </span>adolescentes <span class="blank _f"> </span>somente <span class="blank _e"> </span>quando <span class="blank _e"> </span>o <span class="blank _f"> </span>peso <span class="blank _e"> </span>pré<span class="blank _1"> </span>-</div><div class="t m0 x9 h4 y291 ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank _9"> </span>nã<span class="blank _1"> </span>o <span class="blank _9"> </span>possa <span class="blank _9"> </span>se<span class="blank _1"> </span>r <span class="blank _9"> </span>calculado <span class="blank _9"> </span>ou <span class="blank _8"> </span>o <span class="blank _9"> </span>p<span class="blank _1"> </span>eso <span class="blank _9"> </span>no <span class="blank _9"> </span>1<span class="blank _1"> </span>º </div><div class="t m0 x9 h4 y16c ff2 fs2 fc0 sc0 ls7 ws3">trimestre não possa ser obtido. </div><div class="t m0 x9 h4 y292 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 h4 y293 ff9 fs2 fc0 sc0 ls7 ws7">OBSERVAÇÃO<span class="ff2 ls1c ws3"> </span><span class="ff5 ws2">\uf0e0<span class="ff2 ws3"> <span class="blank _17"> </span>Accioly <span class="blank _17"> </span>sugere <span class="blank _17"> </span>que <span class="blank _16"> </span>deve-se </span></span></div><div class="t m0 x9 h4 y16e ff2 fs2 fc0 sc0 ls7 ws3">empregar <span class="blank _1"> </span>a <span class="blank _1"> </span>classificação <span class="blank _1"> </span>d<span class="blank _1"> </span>a O<span class="blank _1"> </span>MS (2006<span class="blank _1"> </span>/2007<span class="blank _1"> </span>) <span class="blank _1"> </span>(quadros </div><div class="t m0 x9 h4 y16f ff2 fs2 fc0 sc0 ls7 ws3">1 <span class="blank _5"> </span>e <span class="blank _5"> </span>2), <span class="blank _5"> </span>em <span class="blank _5"> </span>idade <span class="blank _5"> </span>e <span class="blank _5"> </span>meses <span class="blank _6"> </span>pa<span class="blank _1"> </span>ra <span class="blank _6"> </span>o <span class="blank _5"> </span>dia<span class="blank _1"> </span>gnóstico <span class="blank _6"> </span>pré<span class="blank _1"> </span>-</div><div class="t m0 x9 h4 y294 ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank _11"> </span>de <span class="blank _1a"> </span>adolescentes <span class="blank _11"> </span>e <span class="blank _1a"> </span>a <span class="blank _11"> </span>seguir <span class="blank _11"> </span>fazer <span class="blank _1a"> </span>a </div><div class="t m0 x9 h4 y171 ff2 fs2 fc0 sc0 ls7 ws3">programação <span class="blank"> </span>d<span class="blank _1"> </span>o <span class="blank"> </span>ganho <span class="blank _6"> </span>de <span class="blank"> </span>peso <span class="blank _6"> </span>recomendado <span class="blank _6"> </span>até <span class="blank _6"> </span>o </div><div class="t m0 x9 h4 y172 ff2 fs2 fc0 sc0 ls7 ws3">termo <span class="blank _4"> </span>(quadro <span class="blank _a"> </span>4<span class="blank _1"> </span>). <span class="blank _a"> </span>Nos <span class="blank _4"> </span>casos <span class="blank _4"> </span>em <span class="blank _a"> </span>que <span class="blank _4"> </span>o <span class="blank _4"> </span>peso <span class="blank _a"> </span>pré<span class="blank _1"> </span>-</div><div class="t m0 x9 h4 y173 ff2 fs2 fc0 sc0 ls7 ws3">gestacional <span class="blank _1a"> </span>não <span class="blank _1a"> </span>é <span class="blank _1a"> </span>conhecido <span class="blank _1a"> </span>ou <span class="blank _1a"> </span>não <span class="blank _1a"> </span>é <span class="blank _1a"> </span>possível </div><div class="t m0 x9 h4 y295 ff2 fs2 fc0 sc0 ls7 ws7">mensurá-<span class="lsa ws3">lo <span class="blank _6"> </span><span class="ls7">(idade <span class="blank _6"> </span>ges<span class="ff4">tacional <span class="blank _5"> </span>\u2265 <span class="blank _6"> </span>14 <span class="blank _6"> </span>semanas) <span class="blank _6"> </span>seguir </span></span></span></div><div class="t m0 x9 h4 y296 ff2 fs2 fc0 sc0 ls7 ws3">conforme o item B. <span class="blank _29"> </span><span class="v2"> </span></div><div class="t m0 x16 h4 y297 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y298 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y299 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y29a ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y120 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y29b ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y29c ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y29d ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y29e ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y29f ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a0 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a1 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a2 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a3 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a4 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a5 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a6 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a7 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a8 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2a9 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2aa ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2ab ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2ac ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2ad ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2ae ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2af ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2b0 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2b1 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 yb0 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x16 h4 y2b2 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x9 hb y2b3 ff3 fs2 fc0 sc0 ls7 ws3">CONSULTAS SUBSEQUENTES<span class="ff2">: </span></div><div class="t m0 xa h4 y2b4 ff2 fs2 fc0 sc0 ls7 ws3">A <span class="blank _1e"> </span>avaliação <span class="blank _1e"> </span>antropométrica <span class="blank _1e"> </span>nas <span class="blank _1e"> </span>c<span class="blank _0"></span>onsultas </div><div class="t m0 x9 h4 y2b5 ff2 fs2 fc0 sc0 ls7 ws3">subsequentes <span class="blank _e"> </span>pode <span class="blank _e"> </span>ser <span class="blank _13"> </span>realizada <span class="blank _f"> </span>co<span class="blank _1"> </span>m <span class="blank _e"> </span>base <span class="blank _e"> </span>na </div><div class="t m0 x9 h4 y2b6 ff2 fs2 fc0 sc0 ls7 ws3">adequação <span class="blank _4"> </span>do <span class="blank _4"> </span>ganho <span class="blank _a"> </span>de<span class="blank _1"> </span> <span class="blank _a"> </span>peso<span class="blank _1"> </span> <span class="blank _a"> </span>semanal <span class="blank _4"> </span>e <span class="blank _4"> </span>total, <span class="blank _4"> </span>de </div><div class="t m0 x9 h4 y2b7 ff2 fs2 fc0 sc0 ls7 ws3">acordo com o quadro 4. </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf9" class="pf w0 h0" data-page-no="9"><div class="pc pc9 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1 y2b8 w7 h1c" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bg9.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">294 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 h4 y4 ff2 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y87 ff3 fs2 fc0 sc0 ls7 ws3">Quadro2: </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pfa" class="pf w0 h0" data-page-no="a"><div class="pc pca w0 h0"><img fetchpriority="low" loading="lazy" class="bi x1 y2b9 w7 h1d" alt="" src="https://files.passeidireto.com/540e49ef-db7d-4c22-90c9-944735831f98/bga.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">Ca<span class="ls7 ws3">pítulo<span class="blank _0"></span> elaborado po<span class="blank _0"></span>r Jamile Nogueira </span></div><div class="t m0 x2 h3 y2 ff1 fs1 fc0 sc0 ls7 ws3">295 </div><div class="t m0 x1 h3 y3 ff1 fs1 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y86 ff3 fs2 fc0 sc0 ls7 ws3"> </div><div class="t m0 x1 hb y87 ff3 fs2 fc0 sc0 ls7 ws7">Quadro3:</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
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