Síndrome de perfusión arterial reversa de feto a feto - Vázquez Martínez, Yovany Enrique; Lemus Valdés, María Teresa (Revista Cubana de Obstetricia y Ginecología, 2023)
<span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*470.52px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02874);" role="presentation">Introducción: <span dir="ltr" style="left: calc(var(--scale-factor)*155.78px); top: calc(var(--scale-factor)*470.52px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00747);" role="presentation">Uno de los temas que presenta más interés en los obstetras es <span dir="ltr" style="left: calc(var(--scale-factor)*501.72px); top: calc(var(--scale-factor)*470.52px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.928818);" role="presentation">el<span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*491.22px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.896377);" role="presentation">relac<span dir="ltr" style="left: calc(var(--scale-factor)*101.36px); top: calc(var(--scale-factor)*491.22px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.926113);" role="presentation">ionado con la gestación gemelar. S<span dir="ltr" style="left: calc(var(--scale-factor)*274.36px); top: calc(var(--scale-factor)*491.22px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.93589);" role="presentation">u diagnóstico nos permite clasificarla como una <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.882609);" role="presentation">gestación <span dir="ltr" style="left: calc(var(--scale-factor)*131.26px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.84462);" role="presentation">de <span dir="ltr" style="left: calc(var(--scale-factor)*150.44px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.897717);" role="presentation">riesgo, <span dir="ltr" style="left: calc(var(--scale-factor)*190.63px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.84552);" role="presentation">en <span dir="ltr" style="left: calc(var(--scale-factor)*209.82px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.927533);" role="presentation">la <span dir="ltr" style="left: calc(var(--scale-factor)*226.37px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.908258);" role="presentation">cual <span dir="ltr" style="left: calc(var(--scale-factor)*254.20px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.927533);" role="presentation">el <span dir="ltr" style="left: calc(var(--scale-factor)*270.80px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.896235);" role="presentation">estudio <span dir="ltr" style="left: calc(var(--scale-factor)*313.26px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.90055);" role="presentation">ecosonográfico <span dir="ltr" style="left: calc(var(--scale-factor)*394.66px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.788922);" role="presentation">es <span dir="ltr" style="left: calc(var(--scale-factor)*412.53px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.93902);" role="presentation">muy <span dir="ltr" style="left: calc(var(--scale-factor)*441.72px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.916696);" role="presentation">importante <span dir="ltr" style="left: calc(var(--scale-factor)*501.58px); top: calc(var(--scale-factor)*511.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.927533);" role="presentation">al <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*532.62px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.919547);" role="presentation">proporcionar <span dir="ltr" style="left: calc(var(--scale-factor)*143.00px); top: calc(var(--scale-factor)*532.62px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.888883);" role="presentation">datos relacionad<span dir="ltr" style="left: calc(var(--scale-factor)*221.30px); top: calc(var(--scale-factor)*532.62px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.900139);" role="presentation">os con el tipo de placentación. <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*553.32px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.929409);" role="presentation">Presentación de caso: <span dir="ltr" style="left: calc(var(--scale-factor)*192.92px); top: calc(var(--scale-factor)*553.32px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.919967);" role="presentation">Se realiza ecografía prenatal del I trimestre para confirmación de <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.912261);" role="presentation">diagnóstico <span dir="ltr" style="left: calc(var(--scale-factor)*145.18px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.914651);" role="presentation">presuntivo <span dir="ltr" style="left: calc(var(--scale-factor)*207.67px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.849118);" role="presentation">de <span dir="ltr" style="left: calc(var(--scale-factor)*230.88px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.913504);" role="presentation">onfalocele, <span dir="ltr" style="left: calc(var(--scale-factor)*295.78px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.877541);" role="presentation">donde <span dir="ltr" style="left: calc(var(--scale-factor)*336.92px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.788922);" role="presentation">se <span dir="ltr" style="left: calc(var(--scale-factor)*358.81px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.866767);" role="presentation">constata <span dir="ltr" style="left: calc(var(--scale-factor)*409.97px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.874714);" role="presentation">embarazo <span dir="ltr" style="left: calc(var(--scale-factor)*468.50px); top: calc(var(--scale-factor)*574.02px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.902907);" role="presentation">gemelar, <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*594.72px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.933639);" role="presentation">monoamniótico, monocorial. Se realiza el diagnóstico de síndrome de perfusión arterial <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*615.42px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.93732);" role="presentation">reversa feto a feto. <span dir="ltr" style="left: calc(var(--scale-factor)*176.24px); top: calc(var(--scale-factor)*615.42px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.9464);" role="presentation">El est<span dir="ltr" style="left: calc(var(--scale-factor)*204.68px); top: calc(var(--scale-factor)*615.42px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.95425);" role="presentation">ado anormal del “corazón” del feto podría identificarse como <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*636.12px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.906026);" role="presentation">una holoacardia; <span dir="ltr" style="left: calc(var(--scale-factor)*162.74px); top: calc(var(--scale-factor)*636.12px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.921978);" role="presentation">pero el grado de malformación que presenta no se ajusta a ninguno de <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*656.82px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.960027);" role="presentation">los criterios de esta clasificación. Teniendo en cuenta el hallazgo precoz y la elevada <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*677.52px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.883474);" role="presentation">mortalidad que se aso<span dir="ltr" style="left: calc(var(--scale-factor)*182.36px); top: calc(var(--scale-factor)*677.52px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.893768);" role="presentation">cia en estos casos se sugirió la opción de interrumpir el embarazo. <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*698.24px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.94661);" role="presentation">Conclusiones: <span dir="ltr" style="left: calc(var(--scale-factor)*155.78px); top: calc(var(--scale-factor)*698.24px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.973309);" role="presentation">El asesoramiento genético referido a las posibles terapias a emplear <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*718.94px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.954246);" role="presentation">estaría limitado en este caso, <span dir="ltr" style="left: calc(var(--scale-factor)*232.82px); top: calc(var(--scale-factor)*718.94px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.995128);" role="presentation">debido a la alta morbimortalidad perinatal, la falta de <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*73.82px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.909315);" role="presentation">experiencia en re<span dir="ltr" style="left: calc(var(--scale-factor)*161.78px); top: calc(var(--scale-factor)*73.82px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.922883);" role="presentation">lación con el tratamiento medicamentoso, y la escasa disponibilidad de <span dir="ltr" style="left: calc(var(--scale-factor)*78.00px); top: calc(var(--scale-factor)*94.52px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.905285);" role="presentation">técnicas para la intervención fetal.