Obstetricia IV

GUIA 4

Obstetricia IV

Eating well during pregnancy is more than simply increasing how much you eat. You must also consider what you eat.

Although you need about 300 extra calories a day — especially later in your pregnancy, when your baby grows quickly — those calories should come from nutritious foods so they can contribute to your baby's growth and development.

Eating Well When You're Pregnant

Do you wonder how it's reasonable to gain 25 to 35 pounds (on average) during your pregnancy when a newborn baby weighs only a fraction of that? Although it varies from woman to woman, this is how those pounds may add up:

    * 7.5 pounds: average baby's weight

    * 7 pounds: extra stored protein, fat, and other nutrients

    * 4 pounds: extra blood

    * 4 pounds: other extra body fluids

    * 2 pounds: breast enlargement

    * 2 pounds: enlargement of your uterus

    * 2 pounds: amniotic fluid surrounding your baby

    * 1.5 pounds: the placenta

Of course, patterns of weight gain during pregnancy vary. It's normal to gain less if you start out heavier and more if you're having twins or triplets — or if you were underweight before becoming pregnant. More important than how much weight you gain is what makes up those extra pounds.

When you're pregnant, what you eat and drink is the main source of nourishment for your baby. In fact, the link between what you consume and the health of your baby is much stronger than once thought. That's why doctors now say, for example, that no amount of alcohol consumption should be considered safe during pregnancy.

The extra food you eat shouldn't just be empty calories — it should provide the nutrients your growing baby needs. For example, calcium helps make and keep bones and teeth strong. While you're pregnant, you still need calcium for your body, plus extra calcium for your developing baby. Similarly, you require more of all the essential nutrients than you did before you became pregnant.

A Nutrition Primer for Expectant Mothers

Whether or not you're pregnant, a healthy diet includes proteins, carbohydrates, fats, vitamins, minerals, and plenty of water. The U.S. government publishes dietary guidelines that can help you determine how many servings of each kind of food to eat every day. Eating a variety of foods in the proportions indicated is a good step toward staying healthy.
Food labels can tell you what kinds of nutrients are in the foods you eat. The letters RDA, which you find on food labeling, stand for recommended daily allowance, or the amount of a nutrient recommended for your daily diet. When you're pregnant, the RDAs for most nutrients are higher.
Here are some of the most common nutrients you need and the foods that contain them:

Nutrient	Needed for	Best sources
Protein	cell growth and blood production	lean meat, fish, poultry, egg whites, beans, peanut butter, tofu
Carbohydrates	daily energy production	breads, cereals, rice, potatoes, pasta, fruits, vegetables
Calcium	strong bones and teeth, muscle contraction, nerve function	milk, cheese, yogurt, sardines or salmon with bones, spinach
Iron	red blood cell production (to prevent anemia)	lean red meat, spinach, iron-fortified whole-grain breads and cereals
Vitamin A	healthy skin, good eyesight, growing bones	carrots, dark leafy greens, sweet potatoes
Vitamin C	healthy gums, teeth, and bones; assistance with iron absorption	citrus fruit, broccoli, tomatoes, fortified fruit juices
Vitamin B6	red blood cell formation; effective use of protein, fat, and carbohydrates	pork, ham, whole-grain cereals, bananas
Vitamin B12	formation of red blood cells, maintaining nervous system health	meat, fish, poultry, milk (Note: vegetarians who don't eat dairy products need supplemental B12)
Vitamin D	healthy bones and teeth; aids absorption of calcium	fortified milk, dairy products, cereals, and breads
Folic acid	blood and protein production, effective enzyme function	green leafy vegetables, dark yellow fruits and vegetables, beans, peas, nuts
Fat	body energy stores	meat, whole-milk dairy products, nuts, peanut butter, margarine, vegetable oils (Note: limit fat intake to 30% or less of your total daily calorie intake)

Actividad 1

Gramática

1.        Transcribe un GN que contenga un artículo indefinido como determinador. Subrayar su núcleo. Escribe el significado de todo el grupo en Español.

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II.            Transcribe un GN que contenga un adjetivo en modo comparativo. Subrayar su núcleo. Escribe el significado de todo el grupo en Español.

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III.          Transcribe un GN que contenga un adjetivo con ed. Subrayar su núcleo. Escribe el significado de todo el grupo en Español.

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IV.          Transcriba una oración que contenga un  GV con verbo modal en presente. Subraya el GV y luego escríbela en Español.

V.         Transcriba una oración que contenga un  GV en Pasiva en  Presente. Subraya el GV y luego escríbela en Español.

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VI.  Transcriba una oración que contenga un  GV con verbo modal en pasado. Subraya el GV y luego escríbela en Español.

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Observa la siguiente oración ,  luego escriba la oración en Español.

Food labels can tell you what kinds of nutrients are in the foods you eat. The letters RDA, which you find on food labeling, stand for recommended daily allowance, or the amount of a nutrient recommended for your daily diet. When you're pregnant, the RDAs for most nutrients are higher.

 

ACTIVIDADES DE COMPRENSION

Realice las siguientes actividades en Español, con información extraída del texto.

I.          Hable del tema del articulo en forma completa.

II.         ¿Para quién es este tipo de dieta ?¿ Que aconseja el autor?

III.        ¿Qué es lo que tiene que comer alguien en este estado? ¿Es Importante el tipo de dieta?

IV        Enumere tipo de vitaminas que debe consumir una mujer en este estado.

V.        Diga el significado de RDA.

VI.       Explique EL POR QUE  se aumenta de peso en este estado.

VII.      ¿Para qué ayuda el calcio?¿ y el ácido fólico?

GUIA NRO

BIRTH DEFECTS

Like most expectant parents, you probably alternate between fantasies about a healthy baby and worries that your baby will have a health problem. Or perhaps you've been told through prenatal screening that your baby might be born with a birth defect.

Many parents assume that all birth defects are severe or even fatal, but the fact is that many are treatable, often immediately after birth — and sometimes even before the baby is born.

It's especially important to know the risk factors involved and how to prevent birth defects. However, it's also important to realize that most babies born with congenital defects are born to two healthy parents.

About Birth Defects

Birth defects are defined as abnormalities of structure, function, or body metabolism that are present at birth. Major birth defects are abnormalities that lead to developmental or physical disabilities or require medical or surgical treatment. There are more than 4,000 different known birth defects, ranging from minor to serious, and although many can be treated or cured, they're the leading cause of death in the first year of life.

According to the March of Dimes, about 150,000 babies are born with birth defects each year in the United States. The American College of Obstetricians and Gynecologists (ACOG) says that 3 out of every 100 babies born in the United States have some kind of major birth defect.

Birth defects can be caused by genetic, environmental, or unknown factors. For most birth defects, the cause is believed to be an interaction of a number of genetic and environmental factors.

Structural or metabolic defects are those in which a specific body part is missing or formed incorrectly; metabolic birth defects are those in which there is an inborn problem in body chemistry. The most common type of major structural defects are heart defects, which affect 1 in 150 babies in the United States.

Other common structural defects include spina bifida, cleft palate, clubfoot, and congenital dislocated hip.

Metabolic defects affect 1 in 3,500 babies and usually involve a missing or incorrectly formed enzyme (a protein necessary for processing chemical substances in the body). Most children with a metabolic birth defect do not have any visible abnormalities, but metabolic defects are usually harmful or can be even fatal. Metabolic defects include Tay-Sachs disease, a fatal disease that affects the central nervous system, and phenylketonuria (PKU), which affects the way the body processes protein.

Defects caused by congenital infections result when a mother gets an infection before or during the pregnancy. Infections that can cause birth defects include rubella (German measles), cytomegalovirus (CMV), syphilis, toxoplasmosis, Venezuelan equine encephalitis, parvovirus, and, rarely, chickenpox. None of these affect 100% of babies whose mothers are infected during pregnancy. If the mother is infected during early pregnancy, rubella carries the highest risk for birth defects (approximately 20%). Because of nearly universal immunization in the United States, rubella is very, very rare and the congenital rubella syndrome is almost never seen. CMV is probably the most common congenital infection and may be associated with intellectual disability (mental retardation) and hearing loss.

Other causes of birth defects include alcohol abuse by the mother. Although a few medications, such as medicines used for epilepsy, are associated with increased risks for certain birth defects, most commonly prescribed drugs are not associated with a significant risk of birth defects.

Causes

Most babies with birth defects are born to two parents with no obvious health problems or risk factors. A woman can do everything her doctor recommends to deliver a healthy child and still have a baby with a birth defect.

In fact, according to the March of Dimes, about 60% of birth defects have unknown causes. The rest are caused by environmental or genetic factors, or some combination of the two.

Genetics play a role in some birth defects. Every cell in the body has chromosomes containing genes that go a long way in determining a person's unique characteristics. One missing or faulty gene can cause a birth defect; this is significant when you consider that we each have about 25,000 genes per cell determining everything from the length of our toes to the color of our eyes.

Where do the faulty genes come from? A child inherits one of each pair of chromosomes (and one of each pair of the genes they contain) from each parent. Sometimes, a disease or defect can occur if only one parent passes along the gene for that disease (even though the child receives a normal gene from the other parent); this is called dominant inheritance and includes birth defects such as achondroplasia (a form of dwarfism) and Marfan syndrome (a disorder characterized by abnormally long fingers, arms, and legs).

Some birth defects occur only when two healthy parents each pass along a faulty gene for the same disease to the child; this is called recessive inheritance and includes conditions such as Tay-Sachs disease or cystic fibrosis.

Finally, some boys inherit disorders from genes passed on to them by their mothers. These defects, which include conditions such as hemophilia and color-blindness, are called X-linked because the genes are carried on the X chromosome. Because males have only the one X chromosome they receive from their mothers (females have two X chromosomes — one from each parent), a faulty gene on the X chromosome they receive will be more likely to cause a problem because they don't have a normal copy of the gene on the other X chromosome that females have. Females who have an altered gene on one X chromosome and an intact on the other may have mild features of the X linked condition.

The number or structure of chromosomes also can cause birth defects. An error during the formation of an egg or sperm can cause a baby to be born with too few or too many chromosomes, or with a damaged chromosome. Birth defects caused by chromosome problems include Down syndrome. The risk of this type of birth defect often increases with the age of the mother.

Environmental causes of birth defects have more to do with the mother's health and exposure to chemicals or diseases. When a mother has certain infections (such as rubella) during pregnancy, it can cause birth defects. Alcohol abuse by the mother causes fetal alcohol syndrome, and certain medications taken by the mother can cause birth defects.

Multifactorial birth defects are caused by a combination of genetic and environmental factors and include congenital heart defects, neural tube defects, and cleft lip and palate.

Although you can take steps to prevent birth defects, a birth defect can happen even if you or your partner have no history of birth defects in your families or if you've had healthy children in the past.

Common Birth Defects

Cleft lip and/or palate occurs when the tissues of the mouth or lip don't form properly during fetal development. A cleft lip is a long opening between the upper lip and the nose. A cleft palate is an opening between the roof of the mouth and the nasal cavity.
In the United States, oral clefting occurs in 1 in 700 to 1,000 births, making it one of the most common major birth defects. Clefts occur more frequently in children of Asian, Latino, or Native American descent; it's believed that a variety of environmental and genetic factors cause clefting, but it's unknown exactly which ones. Clefting is a birth defect that can be surgically repaired after birth.
Cerebral palsy usually isn't detected until weeks to months after birth, depending on the severity of the condition. The term actually refers to a group of conditions affecting control of movement and caused by brain damage. People with cerebral palsy have difficulty controlling the motions their muscles make — which muscles and how severely they are impaired varies from person to person.
About 70% of people with cerebral palsy also have other disabilities, most often intellectual disability (mental retardation). Some children with cerebral palsy may have trouble walking; others may not be able to swallow or speak. Cerebral palsy occurs in 2 to 6 of every 1,000 births; about 10,000 children born in the United States each year develop cerebral palsy.
In most cases, the cause of cerebral palsy isn't known, but some are due to prematurity or brain damage during the last trimester of pregnancy or around the time of birth.
Cerebral palsy can also have a genetic cause or may be due to head injuries or meningitis that occur after birth. Therefore, not all cerebral palsy is considered a birth defect. Therapy to improve motor skills, surgery, and braces and other types of equipment and assistive technology can help improve mobility and muscle control. Speech therapy and occupational therapy can help as well.
Clubfoot is a term used to describe a group of structural defects of the foot and ankle in which the bones, joints, muscles, and blood vessels are formed incorrectly. These defects range from mild to severe and may affect one or both feet. Feet affected by this defect most often point down, turn in, and usually have a limited range of motion.
This is a relatively common birth defect, affecting about 1 in 735 babies born each year in the United States. Boys are affected almost twice as often as girls. The cause is unknown, but it can be treated by applying a cast immediately after birth. This works the majority of the time; if it doesn't, surgery and further casting are usually required.
Congenital hip dislocation occurs when the round upper end of the thighbone doesn't sit inside the socket of the pelvis properly. This can happen in one or both hips. It happens in about 1 or 2 in 1,000 births, more often in girls, and tends to run in families, although the exact cause is unknown. Usually it is detected at birth and treated immediately by placing the baby in a soft sling for 6 to 9 months. If it's not recognized and treated early, surgery may be necessary.
Congenital hypothyroidism, which occurs in about 1 in 3,000 to 4,000 births, results when the baby's thyroid gland (located in the front of the neck) is absent or underdeveloped at birth or if there is a metabolic defect blocking production of thyroid hormone. This causes the infant to be unable to produce adequate amounts of thyroid hormone, which is important for supporting normal growth and brain development.
Developmental delay and permanent intellectual disability can result if the condition is not recognized and treated (with oral thyroid hormone) within the first few weeks of life. Because of this, every state in the United States and most other countries routinely screen all newborns for the condition with a blood test performed shortly after birth.
Fetal alcohol syndrome (FAS) is characterized by slowed growth, mental retardation, abnormalities in facial features, and problems with the central nervous system. Every year between 2,000 and 12,000 babies in the United States are estimated to be born with defects caused by alcohol. FAS cannot be cured or treated, but can be prevented by avoiding alcohol intake during pregnancy.
Neural tube defects (NTDs) occur in the first month of pregnancy when the structure that develops into the brain and spinal cord is forming. Normally, this structure folds into a tube by the 29th day after conception. When the tube doesn't close completely, the baby has an NTD; many babies with these defects are stillborn or die soon after birth.
The two most common forms of NTDs are:

• Spina bifida, which happens when the spinal column doesn't close completely around the spinal cord. It ranges from mild to severe and can be associated with loss of bladder and bowel function, paralysis, and, in some cases, death.
• Anencephaly, which occurs in 3 out of 10,000 births, involves the lack of development of parts of the brain.

NTDs are multifactorial defects, which according to the March of Dimes occur in about 2,500 babies a year in the United States, or 1 out of every 2,000 live births. Studies have shown that the frequency of these defects may be substantially reduced when the mother gets enough folic acid before and during pregnancy, especially during the first trimester.
Women must make sure to receive enough folic acid before they become pregnant because the neural tube closes about 1 week after the first missed menstrual period — so mothers cannot wait to start folic acid when they first realize they're pregnant. For this reason, it is recommended that women take folic acid throughout their reproductive years.