GESTAÇÃO E ATIVIDADE FÍSICA
Autor: Prof. MS Aurélio Machado | Publicado: 2011-02-07T09:33:00-02:00

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 <![endif]-->  Durante o primeiro trimestre, são esperados tanto&nbsp;uma&nbsp; perda de&nbsp; 2 a 3Kg, decorrente de enjôos e vômitos, quanto um ganho &nbsp;de &nbsp;1 &nbsp;a &nbsp;2Kg . A&nbsp;partir&nbsp; daí,&nbsp; espera-se&nbsp; um&nbsp; ganho&nbsp; de 0,450Kg por semana, ou seja, mais ou menos 10 a 11Kg.  Com exemplo, Uma mulher&nbsp;que inicia a gravidez com o peso de 58Kg; deverá ganhar aproximadamente de 9 a 12Kg em 9 meses, dos quais,em média:  aproximadamente 3,5Kg do bebê 
  aproximadamente 2,5Kg de placenta
  1 a 1,5Kg das mamas 
  3Kg (&nbsp;ou litros&nbsp;) de líquido retido, devido às alterações hormonais 
  1 a 4Kg de gordura, que se perdem através da amamentação, pois &nbsp;são&nbsp; utiliza&nbsp;dos como fonte de energia para gerar o leite 
  TOTAL (média) = 11Kg
  
  A falta de atividade física regular é um dos fatores associados a uma susceptibilidade maior a doenças durante e após a gestação. Sendo recomendada na total ausência de qualquer normalidade, mediante avaliação médica especializada.  
  Benefícios de um programa de exercícios pré-natais:  
  Aptidão      aeróbia e muscular apropriada
Facilitação      da recuperação após o trabalho de parto
Maior      bem-estar psicológico materno (que pode ajudar a combater a sensação de      estresse, de ansiedade e/ou depressão experimentadas frequentemente      durante a gravidez)
Estabelecimento      de hábitos permanentes de um estilo de vida saudável.
Retorno      mais rápido ao peso, à força e à flexibilidade de pré-gravidez.
Menos      intervenções obstétricas
Digestão      melhorada e constipação reduzida
Maior      reserva de energia
Lombalgia      reduzida durante a gravidez
  a      diminuição de sintomas gravídicos, 
a diminuição      da tensão no parto,
  auxílio      no retorno venoso prevenindo o aparecimento de varizes de membros      inferiores
melhora      nas condições de irrigação da placenta.
  
  
  As contra-indicações absolutas são:  o      sangramento uterino de qualquer causa, 
a      placentação baixa,
o      trabalho de parto pré-termo, 
o      retardo de crescimento intra-uterino,
os      sinais de insuficiência placentária,
a      rotura prematura de membranas
a      incompetência istmocervical.
Hipertensão      arterial induzida pela gravidez
Colo      uterino incompetente
Sangramento      persistente do segundo para o terceiro trimestre
  
  Na gestação, devem-se preferir os exercícios de   
  Menor      impacto devido às alterações articulares próprias desta fase.
A      intensidade adequada deve ser igual ou inferior a 50% do VO2máx ou da FC      de reserva. 
A      duração em atividades aeróbicas deve ser de 30 minutos ou mais 
Frequência      mínima de três vezes por semana, levando-se em consideração
o      grau de aptidão prévio.
  
  
  Segundo o posicionamento da sociedade brasileira de medicina do esporte e o ACSM é recomendado utilizar as taxações do esforço percebido em vez da FC. Por causa das alterações cronotrópicas que ocorrem durante a gravidez e que tornam menos apropriadas as formulas baseadas na FC para o treinamento padronizado.  
  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Exercícios de flexibilidade são particularmente úteis na gestação para equilibrar a musculatura dorsolombar, abdominal e de assoalho pélvico, que estão em geral contraídos pela postura gravídica.   
  &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Exercícios respiratórios também são importantes por favorecerem a conscientização corporal e promoverem as trocas gasosas. Estes são úteis ainda para o relaxamento e para o auxílio no trabalho de parto.  
  Recomendações do ACOG (America College of Obstetricians and Gynecologists):  
  Treino com FC inferior a 140 bpm;
Não é recomendado o teste de      esforço;
Temperatura corporal materna a no      máximo 38 graus;
Se a gestante é ativa: poucas      modificações no treinamento;
Se a gestante é sedentária:      deves-se fazer atividade de baixa intensidade, como caminhada e natação;
Evitar a posição supinada após o      terceiro trimestre, para não diminuir o débito cardíaco 
Evitar exercícios prolongados de      bipedestação imóvel 
Parar quando se sentirem fadigas      e jamais chegar a exaustão 
Evitar traumatismos na barriga e      exercícios que aumentam a incidência de quedas 
A gravidez requer um adicional de      300kcal/dia, mulheres que se exercitam devem ter um cuidado adicional com      a alimentação 
Aumentar a dissipação do calor e      hidratação, principalmente nos 3 primeiros meses 
Muitas alterações morfológicas da      gravidez persistem por quatro a seis semanas após o parto, por isso a      rotina de exercícios pré-gravidez deve ser retomada gradualmente 
Usar a escala subjetiva de      esforço 11 a 13 na escala de 6 a 20


Escrito por: Prof. Ms. Fernando Borges &amp; Prof. Ms. Aurélio Machado