<?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>S0300-90412021000900715</article-id>
<article-id pub-id-type="doi">10.24245/gom.v89i9.5309</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Amputación cervical por pesario, en gestación gemelar como prevención de parto pretérmino. Reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Cervical amputation by use of cervical pessary in a twin pregnancy as prevention of preterm birth. Case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-García]]></surname>
<given-names><![CDATA[Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallego-De Largy]]></surname>
<given-names><![CDATA[Cristina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Llamazares-Alonso]]></surname>
<given-names><![CDATA[Anais]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gómez-Álvarez]]></surname>
<given-names><![CDATA[Susana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ceballos-Medina]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vilares-Calvo]]></surname>
<given-names><![CDATA[Silvia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Marqués de Valdecilla  ]]></institution>
<addr-line><![CDATA[Santander Cantabria]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario Marqués de Valdecilla  ]]></institution>
<addr-line><![CDATA[Santander Cantabria]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Universitario Marqués de Valdecilla  ]]></institution>
<addr-line><![CDATA[Santander Cantabria]]></addr-line>
<country>España</country>
</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>9</numero>
<fpage>715</fpage>
<lpage>720</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412021000900715&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412021000900715&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412021000900715&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  ANTECEDENTES: El parto pretérmino es la principal causa de muerte neonatal (la tasa mundial de parto pretérmino se estima en 11%) y se relaciona con un aumento sustancial de la mortalidad perinatal y de la morbilidad neonatal a largo plazo, incluidos los déficits del desarrollo psicomotor. Debido a que la tasa de parto pretérmino sigue en aumento, la predicción, detección temprana y la identificación de embarazadas con alto riesgo de parto pretérmino es útil porque permite aumentar el control prenatal e indicar tratamientos preventivos, como el pesario cervical.  CASO CLÍNICO: Paciente de 32 años, acudió a la consulta ordinaria de alto riesgo obstétrico debido a embarazo gemelar. Se objetivó la dinámica uterina irregular y la cervicometría de 11 mm con canalización. Se prescribió tratamiento tocolítico, maduración pulmonar fetal y se le colocó un pesario cervical. A las 33 semanas se finalizó el embarazo mediante cesárea urgente, por parto activo y segundo feto en podálica. Al extraer el pesario, antes de la cirugía, se advirtió la necrosis completa y el colgajo únicamente unido por un mínimo pedículo al labio anterior cervical. Nacieron dos varones con Apgar 9-9 y 6-9, respectivamente. Al finalizar la cirugía se revisó el canal cervical y se confirmaron los hallazgos; se procedió a la exéresis. La pieza se envió para estudio anatomopatológico.  CONCLUSIONES: El pesario parece ser una alternativa terapéutica eficaz y sencilla para prevenir el parto pretérmino en embarazos gemelares, aunque no está exenta de complicaciones. La exploración mediante especuloscopia en la consulta podría ayudar a prevenirlas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  BACKROUND: Preterm labor is one of the most common causes (up to 11 %) of neonatal deaths worldwide. It is related to an increase of perinatal mortality and long-term neonatal mobility such as psychomotor development. Due to the increase of preterm delivery, it is of interest to predict and detect high risk pregnant women who would benefit from regular follow up and treatment such as cervical pessary.  CASE PRESENTATION: A thirty-two-year-old pregnant woman who was seenby a high risk consult due to twin pregnancy. In one of the consultations, irregular uterine activity was detected as well as short cervical length (11 mm) and funneling. She was admitted to hospital for tocolysis, and two doses of glucocorticoids were given to aid lung maturation before delivery. Before she was discharged, a cervical pessary was inserted. She attended hospital in active labor at week 33 gestation. As the second fetus was in breech position, an urgent cesarean section was performed. Prior to the surgery, when removing the pessary, complete necrosis of the cervix was observed, leaving only a flap hanging from the cervix by a small pedicle from the anterior lip. Two live males were delivered, whose Apgar were 9-9 and 6-9. At the end of the surgery, the cervical channel was revised and the who cervix was excised and sent for histopathology study.  FINDINGS: Cervical pessary is known as an efficient and easy prevention of preterm birth in twin pregnancies; however, it is associated with certain risks. It is important to examine the correct placement during follow up.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Parto pretérmino]]></kwd>
<kwd lng="es"><![CDATA[mortalidad]]></kwd>
<kwd lng="es"><![CDATA[mortalidad perinatal]]></kwd>
<kwd lng="es"><![CDATA[pesario cervical]]></kwd>
<kwd lng="es"><![CDATA[cesárea]]></kwd>
<kwd lng="es"><![CDATA[semanas de embarazo]]></kwd>
<kwd lng="en"><![CDATA[Preterm labor]]></kwd>
<kwd lng="en"><![CDATA[Deaths]]></kwd>
<kwd lng="en"><![CDATA[Perinatal death]]></kwd>
<kwd lng="en"><![CDATA[Cervical pessary]]></kwd>
<kwd lng="en"><![CDATA[Twin pregnancy]]></kwd>
<kwd lng="en"><![CDATA[Cesarean section]]></kwd>
<kwd lng="en"><![CDATA[Gestational age]]></kwd>
</kwd-group>
</article-meta>
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