<?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>S0300-90412018000300009</article-id>
<article-id pub-id-type="doi">10.24245/gom.v86i3.1829</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Síndrome de Eisenmenger en una paciente embarazada de 21 años]]></article-title>
<article-title xml:lang="en"><![CDATA[Eisenmenger syndrome in 21-year pregnant patient]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Fajardo-Ruiz]]></surname>
<given-names><![CDATA[Lizbeth Sabrina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Novelo]]></surname>
<given-names><![CDATA[Rodrigo Gaspar]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bobadilla-Rosado]]></surname>
<given-names><![CDATA[Luis Orlando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Méndez]]></surname>
<given-names><![CDATA[Nina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Carro]]></surname>
<given-names><![CDATA[Salvador]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Marista de Mérida Escuela de Medicina ]]></institution>
<addr-line><![CDATA[Yucatán ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad Marista de Mérida Escuela de Ciencias de la Salud ]]></institution>
<addr-line><![CDATA[Yucatán ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital General O&#8217;Horan Unidad de Vigilancia Epidemiológica Hospitalaria ]]></institution>
<addr-line><![CDATA[Mérida ]]></addr-line>
<country>Yucatán</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<volume>86</volume>
<numero>3</numero>
<fpage>224</fpage>
<lpage>229</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412018000300009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412018000300009&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412018000300009&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES El síndrome de Eisenmenger es la cardiopatía congénita con mayor riesgo de mortalidad de las embarazadas.  CASO CLÍNICO: Paciente primigesta de 21 años, con síndrome de Eisenmenger e insuficiencia cardiaca grado III NYHA e hipertensión arterial sistémica. El embarazo se interrumpió mediante cesárea a las 30 semanas, con recién nacido vivo de 1000 g, Apgar 3-7, 32 semanas de gestación por Capurro. Seis días después de la cesárea la paciente falleció debido a choque cardiogénico. El neonato falleció de insuficiencia respiratoria el décimo segundo día de vida extrauterina.  CONCLUSIONES El caso aquí descrito permite reflexionar acerca de las oportunidades de mejora en la atención de las pacientes con síndrome de Eisenmenger. En el primer nivel de atención es importante centrarse en la educación y consejería específicas que permitan comprender a la paciente y su pareja los riesgos implícitos de su afección, pues la alternativa más segura hubiera sido evitar el embarazo. En el segundo nivel de atención ha de favorecerse siempre la práctica basada en evidencia y correcta coordinación en los equipos de salud que, en este caso particular, hubiera permitido que la paciente desde la semana 14 hubiera sido referida para atención altamente especializada que hubiese podido incrementar las probabilidades de supervivencia de ella y el neonato.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND  Eisenmenger syndrome is congenital heart disease with a higher risk of mortality for pregnant women.  CLINICAL CASE 21-years women with Eisenmenger syndrome, whose pregnancy was accompanied by class III NYHA heart failure and systemic arterial hypertension. Pregnancy was interrupted at 30 weeks by caesarean section. Six days after the caesarean section, the patient died due to cardiogenic shock.  CONCLUSIONS The case described here allows us to reflect on the opportunities for improvement in the care of patients with Eisenmenger syndrome. At the first level of care, it is important to focus on specific education and counseling that allows the patient and her partner to understand the implicit risks of their condition, since the safest alternative would have been to avoid pregnancy. At the second level of care, the practice based on evidence and correct coordination in the health teams should always be favored, which in this particular case would have allowed the patient, since week 14, to have been referred for highly specialized care could increase the chances of survival of her and the neonate.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Síndrome de Eisenmenger]]></kwd>
<kwd lng="es"><![CDATA[paciente embarazada]]></kwd>
<kwd lng="es"><![CDATA[enfermedad cardiaca congénita]]></kwd>
<kwd lng="es"><![CDATA[muerte materna]]></kwd>
<kwd lng="es"><![CDATA[insuficiencia cardiaca]]></kwd>
<kwd lng="en"><![CDATA[Eisenmenger syndrome]]></kwd>
<kwd lng="en"><![CDATA[Pregnant patient]]></kwd>
<kwd lng="en"><![CDATA[CongenitaPheart disease]]></kwd>
<kwd lng="en"><![CDATA[Maternal death]]></kwd>
<kwd lng="en"><![CDATA[Heart failure]]></kwd>
</kwd-group>
</article-meta>
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