<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412021001100010</article-id>
<article-id pub-id-type="doi">10.24245/gom.v89i11.5584</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Acretismo placentario en el primer trimestre del embarazo como causa de choque hipovolémico: reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Placentary acretism in the first quarter of pregnancy as a cause of hypovolemic shock: a case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Flores-Rosas]]></surname>
<given-names><![CDATA[Eva Mariana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Blancas-Camacho]]></surname>
<given-names><![CDATA[Daniela Eslineri]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Casillas-Barrera]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Solórzano-Aguilar]]></surname>
<given-names><![CDATA[Melina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Hernández]]></surname>
<given-names><![CDATA[Verónica Yazmín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramírez-Uribe]]></surname>
<given-names><![CDATA[Ronnie Darío]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Vida  ]]></institution>
<addr-line><![CDATA[León Guanajuato]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado Hospital 1° de Octubre ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital de la Mujer  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital de la Mujer  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af5">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado Hospital 1° de Octubre ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af6">
<institution><![CDATA[,Hospital de la Mujer  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2021</year>
</pub-date>
<volume>89</volume>
<numero>11</numero>
<fpage>913</fpage>
<lpage>917</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412021001100010&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412021001100010&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412021001100010&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES:  El acretismo es la adherencia anormal de la placenta al miometrio debida a la ausencia parcial o total de la decidua basal y desarrollo incompleto de la capa de Nitabuch.  CASO CLÍNICO:  Paciente de 45 años, con antecedente de tres embarazos, dos abortos, una cesárea y amenorrea de 12 semanas. El padecimiento actual se inició dos días antes, con sangrado transvaginal intermitente. A su ingreso a Urgencias se encontró con datos de bajo gasto e inmediatamente pérdida del estado de alerta; tensión arterial 40-20 mmHg, frecuencia cardiaca de 125 lpm. La parte posterior del cuello uterino se encontró dehiscente, con sangrado transvaginal abundante, prueba inmunológica de embarazo positiva, fracción &#946;-GCH de 2878 mU/mL. Al asociar los datos de la exploración física se integró el diagnóstico de aborto incompleto y se ingresó a la unidad tocoquirúrgica, para legrado uterino instrumentado.  CONCLUSIONES:  De acuerdo con las búsquedas bibliográficas, todo indica que éste es el primer reporte mexicano de un caso de acretismo placentario en el primer trimestre del embarazo. Se sugiere la búsqueda de factores de riesgo que permitan la sospecha y faciliten establecer el diagnóstico de acretismo placentario a partir de las primeras semanas de embarazo para evitar desenlaces obstétricos fatales.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND:  Accretism is the abnormal adherence of the placenta to the myometrium due to partial or total absence of the basal decidua and incomplete development of the Nitabuch's layer.  CLINICAL CASE:  45-year-old patient, with a history of three pregnancies, two abortions and one cesarean section; amenorrhea of 12 weeks. The current condition started two days earlier, with intermittent transvaginal bleeding. On admission to the ED she was found to have low output and immediate loss of alertness; blood pressure 40-20 mmHg, heart rate 125 bpm. The posterior cervix was found to be dehiscent, with abundant transvaginal bleeding, positive immunological pregnancy test, HCG fraction 2878 mU/mL. By associating the physical examination data, the diagnosis of incomplete abortion was integrated, and she was admitted to the tocosurgical unit, for instrumented uterine curettage.  CONCLUSIONS:  According to the bibliographic searches, everything indicates that this is the first Mexican report of a case of placental accretism in the first trimester of pregnancy. It is suggested to search for risk factors that allow suspicion and facilitate the diagnosis of placental accretism from the first weeks of pregnancy to avoid fatal obstetric outcomes.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Placenta]]></kwd>
<kwd lng="es"><![CDATA[decidua]]></kwd>
<kwd lng="es"><![CDATA[Nitabuch]]></kwd>
<kwd lng="es"><![CDATA[primer trimestre del embarazo]]></kwd>
<kwd lng="es"><![CDATA[cesárea]]></kwd>
<kwd lng="es"><![CDATA[aborto incompleto]]></kwd>
<kwd lng="es"><![CDATA[prueba inmunológica de embarazo]]></kwd>
<kwd lng="es"><![CDATA[abosrto espontáneo]]></kwd>
<kwd lng="es"><![CDATA[presión sanguínea]]></kwd>
<kwd lng="en"><![CDATA[Placenta]]></kwd>
<kwd lng="en"><![CDATA[Decidua]]></kwd>
<kwd lng="en"><![CDATA[Nitabuch]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy trimester, first]]></kwd>
<kwd lng="en"><![CDATA[Cesarean section]]></kwd>
<kwd lng="en"><![CDATA[Abortion, incomoplete]]></kwd>
<kwd lng="en"><![CDATA[Pregnancy tests, immunologic]]></kwd>
<kwd lng="en"><![CDATA[Blood pressure]]></kwd>
<kwd lng="en"><![CDATA[Miscarriage]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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