<?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>S0300-90412019000900605</article-id>
<article-id pub-id-type="doi">10.24245/gom.v87i9.3195</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Parto gemelar asincrónico: informe de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Asynchronous twin birth: Case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Benito-Vielba]]></surname>
<given-names><![CDATA[Marta]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Álvarez-Sarrado]]></surname>
<given-names><![CDATA[Leticia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Laborda-Gotor]]></surname>
<given-names><![CDATA[Ramiro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Tiempo-Marqués]]></surname>
<given-names><![CDATA[Pilar Del]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Crespo-Esteras]]></surname>
<given-names><![CDATA[Raquel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castán-Mateo]]></surname>
<given-names><![CDATA[Sergio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Miguel Servet  ]]></institution>
<addr-line><![CDATA[Zaragoza ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario Miguel Servet  ]]></institution>
<addr-line><![CDATA[Zaragoza ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Universitario Miguel Servet  ]]></institution>
<addr-line><![CDATA[Zaragoza ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2019</year>
</pub-date>
<volume>87</volume>
<numero>9</numero>
<fpage>605</fpage>
<lpage>609</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412019000900605&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412019000900605&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412019000900605&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  ANTECEDENTES: El parto gemelar asincrónico consiste en diferir el nacimiento del segundo gemelo, cuando el del primero se produce de manera inevitable en etapas tempranas de la gestación.  CASO CLÍNICO: Paciente de 39 años, con embarazo gemelar bicorial, logrado después de un tratamiento de fecundación in vitro. Atendida en el Hospital Universitario Miguel Servet por amenaza de parto prematuro. A su ingreso se comprobó la muerte del primer gemelo y se decidió extraerlo en la semana 23 + 2 semanas. Posteriormente se objetivó la retracción cervical, con dilatación de 2-3 cm y cese de la dinámica uterina. La bolsa amniótica del segundo gemelo permaneció íntegra, sin signos de pérdida del bienestar fetal, por lo que se intentó el parto asincrónico. Durante el intervalo entre ambos gemelos se administraron cuatro ciclos de fármacos tocolíticos con atosiban y maduración pulmonar fetal con corticoides por amenaza de parto prematuro. Finalmente, se retiró el cerclaje a las 34 + 2 semanas del embarazo, por dinámica uterina regular, aún con la administración de tocolíticos, produciéndose el parto del segundo gemelo. El recién nacido pesó 1810 g, con Apgar de 9 al minuto y de 10 a los 5 minutos, y pH del cordón de 7.39. Su evolución fue favorable y permaneció en la unidad de cuidados intermedios neonatales durante 13 días, para darlo de alta con 2070 g. El estudio posmortem del primer gemelo no reportó expresión morfológica de la causa de muerte, ni se objetivaron signos de infección. El resultado del array fue normal y el cariotipo fue 46 XY. El estudio microbiológico de la placenta no demostró signos de corioamnionitis. La paciente fue dada de alta tres días posteriores al parto, con evolución satisfactoria y sin contratiempos durante el puerperio.  CONCLUSIONES: El parto diferido del segundo gemelo es una alternativa para embarazos gemelares debidamente seleccionados en los que el parto del primer gemelo se produjo en semanas de prematurez extrema y el feto superviviente puede continuar en gestación hasta alcanzar las semanas que le permitan el mejor pronóstico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  BACKGROUND: Asynchronous twin birth consists in deferring the birth of the second twin, when the first one inevitably occurs in early stages of gestation.  CLINICAL CASE:  A 39-year-old patient with bicorial twin pregnancy, achieved after in vitro fertilization treatment. Served at the Miguel Servet University Hospital due to the threat of premature delivery. Upon admission the death of the first twin was verified and it was decided to perform the delivery at week 23 + 2 weeks. Subsequently, cervical retraction was observed, with 2-3 cm dilation and cessation of uterine dynamics. The amniotic bag of the second twin remained intact, with no signs of loss of fetal well-being, so it was decided to perform the asynchronous delivery attempt. During the interval between the two twins, four cycles of tocolytic drugs with atosiban and fetal pulmonary maturation with corticosteroids were administered due to the threat of premature delivery. Finally, the cerclage was removed at 34 + 2 weeks of pregnancy, due to regular uterine dynamics, even with the administration of tocolytics, giving birth to the second twin. The newborn weighed 1810 g, had Apgar of 9 per minute and 10 at 5 minutes, and cord pH of 7.39. Its evolution was favorable and remained in the neonatal intermediate care unit for 13 days, to discharge it with 2070 g. The postmortem study of the first twin did not report morphological expression of the cause of death, nor were there signs of infection. The result of the array was normal and the karyotype was 46 XY. The microbiological study of the placenta showed no signs of chorioamnionitis. The patient was discharged three days after delivery, with satisfactory evolution and without registering incidents during the puerperium.  CONCLUSIONS:  Deferred delivery of the second twin is an alternative for well-selected twin pregnancies in which the birth of the first twin occurs in weeks corresponding to extreme prematurity since it could prolong pregnancy to a gestational age that improves the prognosis of the second twin .]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Parto diferido]]></kwd>
<kwd lng="es"><![CDATA[parto gemelar asincrónico]]></kwd>
<kwd lng="es"><![CDATA[gestación gemelar]]></kwd>
<kwd lng="es"><![CDATA[parto prematuro]]></kwd>
<kwd lng="en"><![CDATA[deferred birth]]></kwd>
<kwd lng="en"><![CDATA[asynchronous twin birth]]></kwd>
<kwd lng="en"><![CDATA[twin pregnancy]]></kwd>
<kwd lng="en"><![CDATA[premature delivery]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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