Gemelos unidos - Vázquez Martínez, Yovany Enrique; Bravo RamirezBravo Ramirez, Maidalys; Lemus Valdés, María Teresa (Revista Cubana de Obstetricia y Ginecología, 2023)
<span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*331.48px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.09566);" role="presentation">Introducción: <span dir="ltr" style="left: calc(var(--scale-factor)*164.54px); top: calc(var(--scale-factor)*331.48px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.963031);" role="presentation">Los gemelos <span dir="ltr" style="left: calc(var(--scale-factor)*234.26px); top: calc(var(--scale-factor)*331.48px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.977589);" role="presentation">unidos <span dir="ltr" style="left: calc(var(--scale-factor)*273.02px); top: calc(var(--scale-factor)*331.48px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.04209);" role="presentation">obedecen a la división tardía e incomplet<span dir="ltr" style="left: calc(var(--scale-factor)*499.72px); top: calc(var(--scale-factor)*331.48px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.0477);" role="presentation">a del <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*347.50px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01042);" role="presentation">disco embrionario monocigó<span dir="ltr" style="left: calc(var(--scale-factor)*236.78px); top: calc(var(--scale-factor)*347.50px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00852);" role="presentation">tico que suele suceder después del <span dir="ltr" style="left: calc(var(--scale-factor)*430.60px); top: calc(var(--scale-factor)*347.50px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.999366);" role="presentation">duodécimo <span dir="ltr" style="left: calc(var(--scale-factor)*493.36px); top: calc(var(--scale-factor)*347.50px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00813);" role="presentation">día de <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*363.52px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02048);" role="presentation">la fertilización. Es un fenómeno esporádico con una prevalencia de 1 en 50 000 a <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.942664);" role="presentation">100 <span dir="ltr" style="left: calc(var(--scale-factor)*116.33px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.942664);" role="presentation">000 <span dir="ltr" style="left: calc(var(--scale-factor)*147.52px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.0112);" role="presentation">nacimientos y <span dir="ltr" style="left: calc(var(--scale-factor)*242.89px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.967137);" role="presentation">solo <span dir="ltr" style="left: calc(var(--scale-factor)*276.48px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.899731);" role="presentation">se <span dir="ltr" style="left: calc(var(--scale-factor)*300.23px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00285);" role="presentation">produce <span dir="ltr" style="left: calc(var(--scale-factor)*356.02px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.981342);" role="presentation">en <span dir="ltr" style="left: calc(var(--scale-factor)*381.64px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.967444);" role="presentation">embarazos <span dir="ltr" style="left: calc(var(--scale-factor)*451.41px); top: calc(var(--scale-factor)*379.60px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.996306);" role="presentation">monocoriales-<span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*395.62px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.989773);" role="presentation">monoamnió<span dir="ltr" style="left: calc(var(--scale-factor)*147.14px); top: calc(var(--scale-factor)*395.62px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02961);" role="presentation">ticos. Las tasas de mortalidad son muy altas y solamente unos pocos <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.906292);" role="presentation">casos <span dir="ltr" style="left: calc(var(--scale-factor)*121.07px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00247);" role="presentation">presentan <span dir="ltr" style="left: calc(var(--scale-factor)*182.12px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.971448);" role="presentation">una <span dir="ltr" style="left: calc(var(--scale-factor)*209.21px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.999373);" role="presentation">anatomía <span dir="ltr" style="left: calc(var(--scale-factor)*266.84px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.06885);" role="presentation">lo <span dir="ltr" style="left: calc(var(--scale-factor)*284.54px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01688);" role="presentation">bastante <span dir="ltr" style="left: calc(var(--scale-factor)*338.92px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02925);" role="presentation">favorable <span dir="ltr" style="left: calc(var(--scale-factor)*397.35px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.981156);" role="presentation">como <span dir="ltr" style="left: calc(var(--scale-factor)*433.76px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.998527);" role="presentation">para <span dir="ltr" style="left: calc(var(--scale-factor)*465.36px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.10309);" role="presentation">permitir <span dir="ltr" style="left: calc(var(--scale-factor)*517.11px); top: calc(var(--scale-factor)*411.66px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.05343);" role="presentation">la <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*427.68px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01478);" role="presentation">separación quirúrgica y sobrevivir a la misma. <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*443.70px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.09363);" role="presentation">Objetivos: <span dir="ltr" style="left: calc(var(--scale-factor)*145.70px); top: calc(var(--scale-factor)*443.70px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.96791);" role="presentation">Exponer <span dir="ltr" style="left: calc(var(--scale-factor)*191.84px); top: calc(var(--scale-factor)*443.70px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.07912);" role="presentation">el <span dir="ltr" style="left: calc(var(--scale-factor)*204.86px); top: calc(var(--scale-factor)*443.70px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.929091);" role="presentation">caso <span dir="ltr" style="left: calc(var(--scale-factor)*231.26px); top: calc(var(--scale-factor)*443.70px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.991237);" role="presentation">de <span dir="ltr" style="left: calc(var(--scale-factor)*247.34px); top: calc(var(--scale-factor)*443.70px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.991127);" role="presentation">un embarazo monocorial monoamniótico de gemelos <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*459.72px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.05721);" role="presentation">unidos, dada su infrecuente presentación en la práctica médica <span dir="ltr" style="left: calc(var(--scale-factor)*445.78px); top: calc(var(--scale-factor)*459.72px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.06831);" role="presentation">y demostrar el <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*475.74px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.03907);" role="presentation">valor del <span dir="ltr" style="left: calc(var(--scale-factor)*135.74px); top: calc(var(--scale-factor)*475.74px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01817);" role="presentation">diagnóstico ultrasonográfico precoz de este tipo de defectos congénitos. <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*491.76px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.03538);" role="presentation">Presentación de caso: <span dir="ltr" style="left: calc(var(--scale-factor)*211.58px); top: calc(var(--scale-factor)*491.76px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.962835);" role="presentation">Pacie<span dir="ltr" style="left: calc(var(--scale-factor)*240.50px); top: calc(var(--scale-factor)*491.76px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01257);" role="presentation">nte de 25 años, nulípara, con antecedentes <span dir="ltr" style="left: calc(var(--scale-factor)*477.76px); top: calc(var(--scale-factor)*491.76px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.987205);" role="presentation">de salud, <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*507.78px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.996891);" role="presentation">que acude a realizarse su ecografía de marcadores <span dir="ltr" style="left: calc(var(--scale-factor)*362.08px); top: calc(var(--scale-factor)*507.78px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.994075);" role="presentation">genéticos <span dir="ltr" style="left: calc(var(--scale-factor)*416.80px); top: calc(var(--scale-factor)*507.78px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.04701);" role="presentation">del <span dir="ltr" style="left: calc(var(--scale-factor)*437.26px); top: calc(var(--scale-factor)*507.78px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.05671);" role="presentation">primer <span dir="ltr" style="left: calc(var(--scale-factor)*476.86px); top: calc(var(--scale-factor)*507.78px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.07477);" role="presentation">trimestre <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*523.80px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02601);" role="presentation">en cumplimiento de <span dir="ltr" style="left: calc(var(--scale-factor)*195.20px); top: calc(var(--scale-factor)*523.80px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.996716);" role="presentation">lo establecido en el subprograma de diagnóstico de anomalías <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*539.82px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.994757);" role="presentation">cromosómicas por estud<span dir="ltr" style="left: calc(var(--scale-factor)*215.12px); top: calc(var(--scale-factor)*539.82px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02757);" role="presentation">ios citogenéticos, y <span dir="ltr" style="left: calc(var(--scale-factor)*323.30px); top: calc(var(--scale-factor)*539.82px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00553);" role="presentation">se realiza <span dir="ltr" style="left: calc(var(--scale-factor)*378.88px); top: calc(var(--scale-factor)*539.82px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00954);" role="presentation">el diagnóstico de embarazo <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*555.84px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02085);" role="presentation">monocorial monoamniótico <span dir="ltr" style="left: calc(var(--scale-factor)*235.64px); top: calc(var(--scale-factor)*555.84px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.987702);" role="presentation">de gemelos <span dir="ltr" style="left: calc(var(--scale-factor)*300.98px); top: calc(var(--scale-factor)*555.84px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.977589);" role="presentation">unidos <span dir="ltr" style="left: calc(var(--scale-factor)*339.64px); top: calc(var(--scale-factor)*555.84px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01792);" role="presentation">de tipo simétricos toracópagos. Se <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*571.86px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00018);" role="presentation">asesoró a la pareja sobre los riesg<span dir="ltr" style="left: calc(var(--scale-factor)*268.64px); top: calc(var(--scale-factor)*571.86px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.996545);" role="presentation">os de asumir una gestación con esta <span dir="ltr" style="left: calc(var(--scale-factor)*467.32px); top: calc(var(--scale-factor)*571.86px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01126);" role="presentation">patología y <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*587.88px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02674);" role="presentation">decidieron <span dir="ltr" style="left: calc(var(--scale-factor)*145.64px); top: calc(var(--scale-factor)*587.88px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.05343);" role="presentation">la <span dir="ltr" style="left: calc(var(--scale-factor)*159.08px); top: calc(var(--scale-factor)*587.88px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01338);" role="presentation">culminación del embarazo. <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.01432);" role="presentation">Conclusion<span dir="ltr" style="left: calc(var(--scale-factor)*145.70px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.952768);" role="presentation">es: <span dir="ltr" style="left: calc(var(--scale-factor)*171.32px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.927373);" role="presentation">La <span dir="ltr" style="left: calc(var(--scale-factor)*192.85px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00129);" role="presentation">ecografía <span dir="ltr" style="left: calc(var(--scale-factor)*252.10px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.04851);" role="presentation">del <span dir="ltr" style="left: calc(var(--scale-factor)*278.06px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.05671);" role="presentation">primer <span dir="ltr" style="left: calc(var(--scale-factor)*323.17px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.07477);" role="presentation">trimestre <span dir="ltr" style="left: calc(var(--scale-factor)*382.50px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.981156);" role="presentation">como <span dir="ltr" style="left: calc(var(--scale-factor)*420.40px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.0058);" role="presentation">marcador <span dir="ltr" style="left: calc(var(--scale-factor)*480.56px); top: calc(var(--scale-factor)*603.90px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.02028);" role="presentation">genético <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*619.92px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(1.00371);" role="presentation">posibilitó el diagnóstico temprano de una malformación de pronóstico desfavorable <span dir="ltr" style="left: calc(var(--scale-factor)*85.08px); top: calc(var(--scale-factor)*635.94px); font-size: calc(var(--scale-factor)*12.00px); font-family: sans-serif; transform: scaleX(0.998235);" role="presentation">para la decisión consensuada de los padres para descontinuar el embarazo.