<?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>S0300-90412017000600403</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Embarazo heterotópico espontáneo. Reporte de un caso y revisión de la bibliografía]]></article-title>
<article-title xml:lang="en"><![CDATA[Spontaneous heterotopic pregnancy. Case report and literature review]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Cruz]]></surname>
<given-names><![CDATA[RG]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tobón-Delgado]]></surname>
<given-names><![CDATA[SR]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[García-Rodríguez]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Escobar-Ponce]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Olguín-Ortega]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Perinatología Dr. Isidro Espinosa de los Reyes  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Perinatología Dr. Isidro Espinosa de los Reyes  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Nacional de Perinatología Dr. Isidro Espinosa de los Reyes  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2017</year>
</pub-date>
<volume>85</volume>
<numero>6</numero>
<fpage>403</fpage>
<lpage>408</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412017000600403&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412017000600403&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412017000600403&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES: el embarazo heterotópico es la coexistencia de una gestación intrauterina y otra extrauterina. Puesto que es una posibilidad excepcional asociada con gran morbilidad y mortalidad materna, su diagnóstico y atención oportuna son decisivos. La fracción &#946; de la hormona gonadotropina coriónica humana y el ultrasonido endovaginal son las opciones de mayor utilidad para el diagnóstico y el acceso quirúrgico laparoscópico es el de elección porque ofrece ventajas en relación con la técnica abierta.  CASO CLÍNICO: paciente con embarazo heterotópico logrado espontáneamente, de 7.4 semanas de gestación. Embarazo ectópico izquierdo roto y el intrauterino con vitalidad corroborada. Ingresó al servicio de Urgencias por amenorrea y dolor abdominal. El embarazo ectópico roto se corroboró mediante salpingectomía laparoscópica, con hemoperitoneo de 800 cc. Gracias al adecuado control prenatal se logró un embarazo que finalizó por vía abdominal, con trabajo de parto en fase latente y feto en presentación pélvica. El recién nacido fue de sexo femenino, de 34 semanas de gestación.  CONCLUSIONES: la atención multidisciplinaria, la identificación de los factores de riesgo, la sospecha clínica y el apoyo de estudios de gabinete permitieron el diagnóstico y la intervención quirúrgica de mínima invasión de forma oportuna, con resultados favorables transquirúrgicos y el nacimiento viable, a las 34 semanas, del embrión coexistente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND: The heterotopic pregnancy is the coexistence is an intrauterine and extrauterine gestation, although the frecuency of presentation is rare, it is associated with a high maternal morbidity and mortality, reason why a diagnosis and timely management are the cornerstone of these cases. The &#946; fraction of the human chorionic gonadotropin hormone and the endovaginal ultrasound are the most useful tools in the diagnosis and the laparoscopic surgical approach has been proposed as the best choice since it offers advantages over an open technique approach.  CLINICAL CASE: The case of a spontaneous heterotopic pregnancy of 7.4 weeks of gestation was reported, with a ruptured left ectopic pregnancy and an intrauterine pregnancy with corroborated vitality, emergency admission for amenorrhea and abdominal pain, corroborating a ruptured ectopic pregnancy with hemoperitoneum by means of laparoscopic salpingectomy, obtaining hemoperitoneum of 800 cc, later with an adequate prenatal control, the pregnancy was resolved abdominal route by indication of labor in latent phase and fetus in pelvic presentation, a female newborn of 34 weeks of gestation was obtained.  CONCLUSION: The multidisciplinary care, the identification of risk factors, clinical suspicion and the support of cabinet studies allowed the diagnosis and surgical approach of minimal invasion in a timely manner, with favorable transsurgical results and a viable pregnancy of 34 weeks of coexisting embryo.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[embarazo heterotópico]]></kwd>
<kwd lng="es"><![CDATA[embarazo ectópico]]></kwd>
<kwd lng="es"><![CDATA[hemoperitoneo]]></kwd>
<kwd lng="en"><![CDATA[Heterotopic pregnancy]]></kwd>
<kwd lng="en"><![CDATA[Ectopic pregnancy]]></kwd>
<kwd lng="en"><![CDATA[hemoperitoneum]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mj G]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Heterotopic pregnancy in natural conception]]></article-title>
<source><![CDATA[J Hum Reprod Sci]]></source>
<year>2008</year>
<volume>1</volume>
<page-range>37-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Russman]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[MGruner]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Jiang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Schnatz]]></surname>
<given-names><![CDATA[PF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous Heterotopic Pregnancy: A Case Report]]></article-title>
<source><![CDATA[Gynecol Obstet (Sunnyvale)]]></source>
<year>2015</year>
<volume>5</volume>
<numero>318</numero>
<issue>318</issue>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Barrenetxea Gorka]]></surname>
</name>
<name>
<surname><![CDATA[Rementeria]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Lorea]]></surname>
</name>
<name>
<surname><![CDATA[Lopez de Larruzea]]></surname>
<given-names><![CDATA[Arantzua]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Heterotopic pregnancy: two cases and a comparative review]]></article-title>
<source><![CDATA[Fertil Steril]]></source>
<year>2007</year>
<volume>417</volume>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jin-Bo]]></surname>
<given-names><![CDATA[Li]]></given-names>
</name>
<name>
<surname><![CDATA[Zhi]]></surname>
<given-names><![CDATA[Kong Ling]]></given-names>
</name>
<name>
<surname><![CDATA[Jian-Bo]]></surname>
<given-names><![CDATA[Yang]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Management of Heterotopic Pregnancy Experience From 1 Tertiary Medical Center]]></article-title>
<source><![CDATA[Medicine]]></source>
<year>2016</year>
<volume>95</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[X]]></given-names>
</name>
<name>
<surname><![CDATA[Geng]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Xia]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Zhai]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Zhang]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk Factors and Early Predictors for Heterotopic Pregnancy after In Vitro Fertilization]]></article-title>
<source><![CDATA[PLoS ONE]]></source>
<year>2015</year>
<volume>10</volume>
<numero>10</numero>
<issue>10</issue>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fylstra]]></surname>
<given-names><![CDATA[DL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ectopic Pregnancy not within the fallopin tube etiology, diagnosis and treatment]]></article-title>
<source><![CDATA[Am J Obstet Gynecol apr]]></source>
<year>2012</year>
<page-range>289-99</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Van-Mello]]></surname>
<given-names><![CDATA[NM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ectopic pregnancy how the diagnostic and therapeutic management has changed]]></article-title>
<source><![CDATA[Fertil Steril!]]></source>
<year>2012</year>
<volume>98</volume>
<page-range>1066-73</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Taran]]></surname>
<given-names><![CDATA[FA]]></given-names>
</name>
<name>
<surname><![CDATA[Kagan]]></surname>
<given-names><![CDATA[KO]]></given-names>
</name>
<name>
<surname><![CDATA[Hübner]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Hoopmann]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Wallwiener]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Dtsch Arztebl]]></article-title>
<collab>Brucker S: The diagnosis and treatment of ectopic pregnancy</collab>
<source><![CDATA[Int]]></source>
<year>2015</year>
<volume>112</volume>
<page-range>693-704</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Serpil]]></surname>
<given-names><![CDATA[Telci]]></given-names>
</name>
<name>
<surname><![CDATA[Cihan]]></surname>
<given-names><![CDATA[Kaya]]></given-names>
</name>
<name>
<surname><![CDATA[Levent]]></surname>
<given-names><![CDATA[Ysar]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Spontaneous Heterotopic Pregnancy Causing Tubal Rupture in a Patient with Intrauterine Device in-situ]]></article-title>
<source><![CDATA[Medical Journal of Bakirköy]]></source>
<year>2014</year>
<volume>10</volume>
<numero>3</numero>
<issue>3</issue>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Soriano]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Vicus]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Schonman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Long-term outcome after laparoscopic treatment of heterotopic pregnancy 19 cases]]></article-title>
<source><![CDATA[J Minim Invasive Gynecol]]></source>
<year>2010</year>
<volume>17</volume>
<page-range>321-4</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
