<?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>S0300-90412018001100749</article-id>
<article-id pub-id-type="doi">10.24245/gom.v86i11.2392</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Anemia hemolítica fetal rápidamente progresiva en el pretérmino tardío: reporte de caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Rapidly progressive fetal hemolytic anemia in the late preterm: case report and literature review]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tipiani-Rodríguez]]></surname>
<given-names><![CDATA[Oswaldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rosales-Cerrillo]]></surname>
<given-names><![CDATA[Hugo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arévalo-Ruíz]]></surname>
<given-names><![CDATA[Hernán Segundo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Garay-Gutiérrez]]></surname>
<given-names><![CDATA[Víctor]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aburto-Pitot]]></surname>
<given-names><![CDATA[Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hinojosa-Andía]]></surname>
<given-names><![CDATA[Lucy Johanna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hematología Guidepoint  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Francia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hematología Guidepoint  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Francia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hematología Guidepoint  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Francia</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>11</numero>
<fpage>749</fpage>
<lpage>754</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412018001100749&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412018001100749&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412018001100749&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES: La isoinmunización Rh es el principal factor de riesgo de anemia fetal. Cuando ésta es moderada o severa la transfusión intrauterina antes de las 34 semanas, y el nacimiento del feto luego de las 37, son las opciones de tratamiento más aceptadas.  CASO CLÍNCO: Paciente de 29 años, con 34 semanas de embarazo, con antecedentes de tres gestaciones que terminaron en dos partos y una cesárea e isoinmunización Rh con secuela neurológica por anemia hemolítica. Hallazgo de Coombs indirecto positivo 1/512 y velocidad pico sistólica de la arteria cerebral media de 57 cm/s. Registro cardiotocográfico reactivo y seguimiento ambulatorio semanal. Retornó a Urgencias debido a la percepción de contracciones uterinas esporádicas. El feto se encontró con 140 lpm, peso de 2760 g y cuantificaciones correspondientes a anemia leve. La cordocentesis reportó Hb = 7.7 g/dL; &#8220;O&#8221; Rh (+). El embarazo terminó mediante cesárea con el nacimiento de una niña de 2702 g, Apgar 9/9, hemoglobina neonatal de 7.9 y 7 g/dL, bilirrubina total de 6.8 y 10.71 mg/dL (a las 4 y 7 horas después del nacimiento). Se efectuó exanguinotransfusión en dos oportunidades por anemia recidivante, fototerapia intensiva durante 5 días, fue dada de alta a los 25 días.  CONCLUSIONES: Es importante analizar y cuantificar los riesgos de prolongar el embarazo más allá de las 34 semanas y aplicar transfusión intrauterina versus interrumpirlo y continuar el tratamiento de forma extrauterina; después de las 35 semanas los riesgos de los procedimientos superan los del parto pretérmino.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKGROUND: Rh isoimmunization is the main risk factor for fetal anemia. When this is moderate or severe intrauterine transfusion before 34 weeks, and the birth of the fetus after 37, are the most accepted treatment options.  CLINICAL CASE:  A 29-year-old patient, 34 weeks pregnant, with a history of three pregnancies that ended in two deliveries and a C-section and Rh isoimmunization with neurological sequelae due to hemolytic anemia. Finding of positive indirect Coombs 1/512 and VPS-ACM = 57 cm/s. Reagent cardiotocographic record and weekly ambulatory follow-up. He returned to the Emergency Department due to the perception of sporadic uterine contractions. The fetus was found with 140 bpm, weight of 2760 g and quantifications corresponding to mild anemia. The cordocentesis reported Hb = 7.7 g/dL; &#8220;O&#8221; Rh (+). The pregnancy was terminated by caesarean section with the birth of a girl of 2702 g, Apgar 9/9, neonatal hemoglobin of 7.9 and 7 g/dL, total bilirubin = 6.8 and 10.71 mg/dL (at 4 and 7 hours after birth). Exchange transfusion was performed twice due to recurrent anemia, intensive phototherapy for 5 days, and was discharged after 25 days.  CONCLUSIONS: It is important to analyze and quantify the risks of prolonging a pregnancy beyond 34 weeks and apply intrauterine transfusion versus interrupting it and continuing the treatment extrauterine; After 35 weeks, the risks of the procedures surpass those of preterm delivery.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Isoinmunización Rh]]></kwd>
<kwd lng="es"><![CDATA[transfusión intrauterina]]></kwd>
<kwd lng="es"><![CDATA[anemia hemolítica]]></kwd>
<kwd lng="es"><![CDATA[contracciones uterinas]]></kwd>
<kwd lng="es"><![CDATA[cordocentesis]]></kwd>
<kwd lng="es"><![CDATA[cesárea]]></kwd>
<kwd lng="en"><![CDATA[Rh isoimmunization]]></kwd>
<kwd lng="en"><![CDATA[Intrauterine transfusion]]></kwd>
<kwd lng="en"><![CDATA[Hemolytic anemia]]></kwd>
<kwd lng="en"><![CDATA[Uterine contractions]]></kwd>
<kwd lng="en"><![CDATA[Cordocentesis]]></kwd>
<kwd lng="en"><![CDATA[Caesarean section]]></kwd>
</kwd-group>
</article-meta>
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