Clinica e Investigacion en Ginecologia y Obstetricia最新文献

{"title":"Restos ovulares y placentarios (ROP) y nódulo del lecho placentario (NLP) en un istmocele tras un parto vaginal: diagnóstico y corrección laparoscópica","authors":"L. Moreno Leñero ,&nbsp;A. Morales Vicente ,&nbsp;S. Moner Marín ,&nbsp;P. Millares Rubio ,&nbsp;N. Santonja López ,&nbsp;Y. García Sánchez ,&nbsp;J. Gilabert Estellés","doi":"10.1016/j.gine.2024.100994","DOIUrl":"10.1016/j.gine.2024.100994","url":null,"abstract":"<div><h3>Introduction</h3><p>An isthmocele is a disruption of the myometrium that creates a cavity at the level of the hysterorrhaphy because of an impaired cicatrization from a previous caesarean section. In addition to several obstetric and fertility complications, it is possible the presence of retained products of conception inside it. We present the case of an isthmocele without previous cesarean section, with retained products of conception and a placental site nodule.</p></div><div><h3>Symptoms and clinical findings</h3><p>We present a clinical case of a 32-year-old woman, with no history of previous cesarean section, who consulted due to the presence of latent hypogastric pain. After the initial examination and hysteroscopy, the presence of an isthmocele with retained products of conception was revealed.</p></div><div><h3>Therapeutic interventions</h3><p>After laparoscopic correction of the isthmocele, the anatomopathological findings showed the presence of a placental site nodule, a benign entity whose atypical variant is related to epithelioid trophoblastic tumor, which is the rarest form of gestational trophoblastic tumor.</p></div><div><h3>Results</h3><p>After the surgical procedure, the patient remains asymptomatic and without any additional treatment.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 100994"},"PeriodicalIF":0.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parecoxib vs. Dexketoprofeno, en combinación con paracetamol, como analgesia adicional en pacientes que reciben morfina neuraxial para el alivio del dolor postoperatorio en la cesárea: estudio prospectivo, aleatorizado, controlado, doble ciego","authors":"L. Bodden,&nbsp;O. Reyes,&nbsp;G. Cárdenas","doi":"10.1016/j.gine.2024.100993","DOIUrl":"10.1016/j.gine.2024.100993","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the effectiveness of parecoxib vs. dexketoprofen, in combination with paracetamol, as additional analgesia in patients receiving neuraxial morphine for postoperative pain relief in cesarean section.</p></div><div><h3>Methods</h3><p>A total of 380 patients scheduled for a cesarean section received neuraxial morphine for pain management. After the procedure, they were randomized to receive, as additional analgesia, 1<!--> <!-->g of paracetamol intravenously every 6<!--> <!-->h in combination with either 40<!--> <!-->mg of parecoxib intravenously every 12<!--> <!-->h or 50<!--> <!-->mg of dexketoprofen intravenously every 8<!--> <!-->h. A Visual Analog Scale (VAS) was used for evaluation of pain intensity at 12 and 24<!--> <!-->h post-operative. Also, the need for additional analgesics, the time (h) required to start patient mobilization and the presence of adverse effects were recorded.</p></div><div><h3>Results</h3><p>No statistical differences were found between groups in pain intensity, using the VAS-Pain score at 12<!--> <!-->h [(Parecoxib vs. Dexketoprofen): 2.76(4.03) vs 2.97(4.34); p<!--> <!-->=<!--> <!-->0.39)], at 24<!--> <!-->h [(Parecoxib vs. Dexketoprofen): 2.47(4.62) vs 2.84(5.20); p<!--> <!-->=<!--> <!-->0.11)] or in the need for additional analgesics at 12<!--> <!-->h [(Parecoxib vs. Dexketoprofen): 4.21% vs 5.79%; RR<!--> <!-->=<!--> <!-->0.73, 95% CI: 0.33 to 1.77; p<!--> <!-->=<!--> <!-->0.31)] or at 24<!--> <!-->h [(Parecoxib vs. Dexketoprofen): 5.79% vs 4.21%; RR<!--> <!-->=<!--> <!-->1.38, 95% CI: 0.57 to 3.34; p<!--> <!-->=<!--> <!-->0.31)]. There were no differences in mobilization time or in the development of adverse effects.</p></div><div><h3>Conclusion</h3><p>There are no differences concerning the effectiveness of parecoxib vs. dexketoprofen, in combination with paracetamol as additional analgesia in patients receiving neuraxial morphine, for postoperative pain relief in cesarean section.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"52 1","pages":"Article 100993"},"PeriodicalIF":0.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142048524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factores asociados a la depresión posparto en puérperas de un hospital peruano","authors":"H.R. Leveau-Bartra ,&nbsp;J.R. Chávez-Navarro ,&nbsp;L.A. Calle-Vilca ,&nbsp;H.A. Guerrero-Ortiz ,&nbsp;C.E. Mejia-Lengua ,&nbsp;B.M. Luján-Divizzia ,&nbsp;I.K. Leveau-Vásquez ,&nbsp;N.L. Medina-Vásquez ,&nbsp;H.I. Leveau-Vásquez ,&nbsp;F.K. Medina-Vásquez","doi":"10.1016/j.gine.2024.100986","DOIUrl":"10.1016/j.gine.2024.100986","url":null,"abstract":"<div><h3>Background</h3><p>Postpartum depression can lead to situations in new mothers that affect baby care, impacting their feeding by reducing adherence to exclusive breastfeeding. Therefore, it is important to identify the factors associated with this condition.</p></div><div><h3>Objective</h3><p>To determine which sociodemographic factors are associated with postpartum depression in postpartum women at a Peruvian hospital.</p></div><div><h3>Materials and methods</h3><p>Observational, cross-sectional, and analytical research.</p></div><div><h3>Design</h3><p>Case-control research design.</p></div><div><h3>Site</h3><p>Regional Hospital of Ica-Peru.</p></div><div><h3>Participants</h3><p>A total of 173 cases (postpartum women at risk of postpartum depression) were studied and compared with 173 controls (postpartum women without risk of postpartum depression). All participants were surveyed between the months of May and October 2022, 15 to 30 days after delivery.</p></div><div><h3>Interventions</h3><p>Survey.</p></div><div><h3>Main measures</h3><p>Edinburgh Postnatal Depression Scale to obtain the metric of the dependent variable, and a general data sheet to obtain independent variables. The cutoff point for the Edinburgh Scale was ≥ 13.</p></div><div><h3>Results</h3><p>The prevalence of postpartum depression was 18.8% (95% <span>C</span>I<!--> <!-->=<!--> <!-->16.3-21.3). The associated factors were: Age under 20 years OR: 2.2 (95% CI: 1.4-3.4) p<!--> <!-->=<!--> <!-->0.001. Higher education level OR: 4.5 (95% CI: 2.8-7.0) p<!--> <!-->=<!--> <!-->0.000. Single marital status OR: 4.4 (95% CI: 2.8-6.9) p<!--> <!-->=<!--> <!-->0.000. Poor relationship with partner OR: 3.9 (95% CI: 2.4-6.1) p<!--> <!-->=<!--> <!-->0.000. Use of Psychotropic drugs OR: 2.7 (95% CI: 1.7-4.4) p<!--> <!-->=<!--> <!-->0.000. Complications during labor OR: 2.6 (95% CI: 1.6-4.3) p<!--> <!-->=<!--> <!-->0.000. Cesarean delivery OR: 3.3 (95% CI: 2.1-5.1) p<!--> <!-->=<!--> <!-->0.000. History of COVID-19 infection during pregnancy OR: 2.7 (95% CI: 1.7-4.2) p<!--> <!-->=<!--> <!-->0.000. Employment status OR: 3.2 (95% CI: 2.1-5.0) p<!--> <!-->=<!--> <!-->0.000.</p></div><div><h3>Conclusion</h3><p>Postpartum depression is associated with sociodemographic variables in the patient's environment that require timely intervention to reduce negative effects on both the mother and the child.</p><p>.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100986"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0210573X24000492/pdfft?md5=0e3ebe775176163e2a9d3140953f22d4&pid=1-s2.0-S0210573X24000492-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141993895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Synchronous presentation of endometrial adenocarcinoma and incidental paratubal borderline serous tumor: A rare case report","authors":"A.A. Khan,&nbsp;C. Ahluwalia,&nbsp;S. Ahuja","doi":"10.1016/j.gine.2024.100989","DOIUrl":"10.1016/j.gine.2024.100989","url":null,"abstract":"<div><h3>Introduction</h3><p>Paratubal cysts, commonly benign and incidentally found during hysterectomy or salpingectomy, are often termed “hydatid cysts of Morgagni.” While most are benign, borderline and malignant subtypes are rare. This report presents an unusual case of synchronous malignancies involving an endometrioid adenocarcinoma and a paratubal borderline serous tumor, emphasizing the need for careful examination of paratubal cysts.</p></div><div><h3>Main symptoms and/or clinical findings</h3><p>A 61-year-old postmenopausal woman presented with two months of vaginal bleeding and lower abdominal pain. Elevated CEA and CA 19-9 levels were noted. Ultrasonography showed thickened endometrium and moderate pyometra, and MRI revealed a lesion in the upper endometrium involving the myometrium without extrauterine extension. An endometrial biopsy indicated endometrial intraepithelial neoplasia.</p></div><div><h3>Main diagnoses, therapeutic interventions, and outcomes</h3><p>The patient underwent a staging laparotomy, bilateral salpingo-oophorectomy, hysterectomy, and pelvic lymphadenectomy. Histopathology confirmed endometrioid adenocarcinoma (FIGO grade II, stage IB) and identified a left paratubal cyst with borderline serous tumor features. Immunohistochemical analysis supported these findings. The post-operative period was uneventful, and the patient remains under follow-up with no signs of recurrence or metastasis.</p></div><div><h3>Conclusion</h3><p>This case underscores the importance of thorough examination of paratubal cysts. The rare coexistence of endometrioid adenocarcinoma with a borderline serous paratubal tumor highlights the necessity for detailed histopathological and immunohistochemical evaluation in synchronous malignancies. Such meticulous examination ensures accurate diagnosis and appropriate management, potentially enhancing patient outcomes.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100989"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preeclampsia como factor de riesgo de enfermedad cardiovascular en el futuro: etiopatogenia e implicación en la práctica clínica","authors":"M. Moreno López","doi":"10.1016/j.gine.2024.100972","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100972","url":null,"abstract":"<div><p>Preeclampsia is a gestational disorder that associates arterial hypertension and organic disfunction and can have adverse consequence to both mother and fetus in the short term. The main factor implicated in its pathogenesis is an anormal placentation leading to endothelial dysfunction, as well as to the dysregulation of physiological pathways. Last evidence suggests that preeclampsia can also lead to long-terms outcomes, such an increase incidence of chronic disease, renal dysfunction and increased cardiovascular risk. This paper reviews the long-term cardiovascular consequences, their pathogenesis and the implications for clinical practice.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100972"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descripción de un caso. Duplicación del cromosoma 1q: diagnóstico prenatal, manifestaciones ecográficas y pronóstico perinatal","authors":"M.C. Restrepo-Guarnizo ,&nbsp;I. Dávila Neri ,&nbsp;R.L. Aragón Mendoza","doi":"10.1016/j.gine.2024.100968","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100968","url":null,"abstract":"<div><h3>Introduction</h3><p>Mosaicism due to duplication of chromosome 1q is recognized as a cytogenetic anomaly, characterized by low frequency and few cases reported in the literature.</p></div><div><h3>Clinical findings</h3><p>In this case, we present a primigravida patient at 24 weeks of pregnancy, with a fetus displaying abnormal ultrasound findings. These include ventriculomegaly, micrognathia, hypotelorism, and associated diaphragmatic hernia.</p></div><div><h3>Primary diagnoses</h3><p>Amniocentesis was performed, and karyotype analysis revealed a prenatal diagnosis of mos 46,XY,dup(1)(q23q44)[19]/46,XY[41] mosaicism. Subsequently, the patient experienced preterm delivery with early perinatal demise.</p></div><div><h3>Therapeutic interventions and outcomes</h3><p>Due to the lack of evidence regarding fetal therapy and the prenatal diagnosis of this condition, postnatal assessment was awaited for appropriate therapeutic management. Subsequently, the patient had preterm delivery with early perinatal death.</p></div><div><h3>Conclusion</h3><p>Heterogeneity of findings is observed to depend on the size and location of the chromosomal alteration, and factors such as the concurrent development of diaphragmatic hernia are associated with a poorer prognosis and higher rates of mortality due to the degree of pulmonary hypoplasia.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100968"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141439280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome de Joubert: un reto para el diagnóstico prenatal","authors":"V. de Miguel Sánchez,&nbsp;S. López Casal,&nbsp;M. Sánchez-Andrade","doi":"10.1016/j.gine.2024.100973","DOIUrl":"https://doi.org/10.1016/j.gine.2024.100973","url":null,"abstract":"<div><h3>Introduction</h3><p>Joubert syndrome and related disorders constitute an autosomal recessive hereditary disease, whose incidence is estimated at one case per 80,000 to 100,000 live births. It represents a developmental delay secondary to multiple congenital abnormalities, predominantly cerebellar and brainstem.</p></div><div><h3>Clinical findings</h3><p>A 37-year-old pregnant woman with an intermediate risk result in the first trimester chromosome screening. Finding in the second trimester obstetric ultrasound, absence of inferior cerebellar vermis, dysplasia of the superior vermis, vertical disposition of both cerebellar hemispheres and horizontal superior cerebellar peduncles. In the fetal resonance the presence of the «Molar tooth sign» is confirmed.</p></div><div><h3>Main diagnoses</h3><p>Cystic anomalies of the posterior fossa, specifically the Dandy-Walker malformation and Joubert syndrome.</p></div><div><h3>Therapeutic interventions and results</h3><p>Genetic study after amniocentesis, QF-PCR, Arrays CGH, without pathological findings and normal fetal karyotype of 46 XX. Confirmation was achieved by massive sequencing of 13 genes related to Joubert syndrome, evidencing the existence of 2 heterozygous pathogenic variants of the <em>CPLANE1</em> gene, each one from a parent.</p></div><div><h3>Conclusion</h3><p>Joubert Syndrome represents a challenge within prenatal diagnosis, due to its heterogeneous clinical, phenotypic and genetic presentation. This work presents the diagnostic complexity and contributes to the literature another case that allows to improve its future diagnosis.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100973"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141582510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodology and utility of intrapartum ultrasound","authors":"J.A. Sainz-Bueno,&nbsp;C. Fernandez-Conde,&nbsp;L. Castro,&nbsp;R. García-Jiménez,&nbsp;J.A. García-Mejido,&nbsp;C. Borrero","doi":"10.1016/j.gine.2024.100995","DOIUrl":"10.1016/j.gine.2024.100995","url":null,"abstract":"<div><p>The introduction of ultrasound into the delivery room is a challenge in our speciality. Imaging techniques are increasingly used in obstetrics, and we are familiar with ultrasound management and the study of pelvic and foetal structures. Ultrasound has been introduced into the study of labour for decades, with a large number of high quality research papers published in the literature. Various approaches and measurements have been described, and there are parameters that have been shown to have high evidence of intrapartum usefulness, such as assessment of foetal head position. Furthermore, the inaccuracy and subjectivity of the traditional evaluation of labour progress by digital vaginal examination has been demonstrated. All this leads us to support the promotion and implementation of this ultrasound to complement our knowledge and decision-making in delivery. The aim of this review is to describe the appropriate method for this ultrasound evaluation and its main applications in labour.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100995"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0210573X24000583/pdfft?md5=55f1d887e96db244ec6a17e55994cfa0&pid=1-s2.0-S0210573X24000583-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preservación de la fertilidad social o no médica","authors":"M. Galian ,&nbsp;M. Díaz ,&nbsp;C. Díaz-García","doi":"10.1016/j.gine.2024.100970","DOIUrl":"10.1016/j.gine.2024.100970","url":null,"abstract":"<div><p>Fertility preservation for social or non medical reasons is one of the reproductive treatments that has experienced the greatest increase in demand in recent years. The impact of age on a woman's ovarian reserve and oocyte quality is well known. This negatively impacts the rates of spontaneous pregnancy, risk of aneuploidy, miscarriage, and maternal and fetal complications.</p><p>Oocyte cryopreservation, carried out mainly by a healthy population, aims to mitigate the impact of age on ovarian aging and future chances of pregnancy, although it does not exempt itself from other negative consequences from the maternal and fetal health perspective, due to a delay in motherhood.</p><p>This manuscript aims to review the egg freezing treatment in terms of efficacy, safety and cost-effectiveness, since the increase in demand is an indirect reaction to a change in social trend and an increase in women who decide to postpone their motherhood, especially due to the absence of a partner.</p><p>It also emphasizes the ethical aspects of a treatment that only a minority of the population can benefit from due to its private access in most cases. This encounters certain limitations, especially for women who, despite having a good reproductive prognosis due to age, could already be in a situation of premature ovarian insufficiency.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100970"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fetal echocardiography: The technique","authors":"C. Villalain ,&nbsp;B. de la Parte ,&nbsp;E. Gómez Montes ,&nbsp;A. Galindo","doi":"10.1016/j.gine.2024.100991","DOIUrl":"10.1016/j.gine.2024.100991","url":null,"abstract":"<div><p>Evaluation of the fetal heart is an integral part of prenatal care. Congenital heart defects (CHDs) are the most common major congenital anomalies, affecting approximately 0.8–1% of live births. Screening for CHDs has shown to improve perinatal outcomes. The performance of screening programs lies, among others, in the systematization of the sonographic evaluation. This review aims to outline the technique for conducting a basic fetal cardiac examination as well as to report the main indications for referral for advanced echocardiography and succinctly describe the technique for advanced echocardiography and first-trimester evaluation of the fetal heart.</p></div>","PeriodicalId":41294,"journal":{"name":"Clinica e Investigacion en Ginecologia y Obstetricia","volume":"51 4","pages":"Article 100991"},"PeriodicalIF":0.1,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}