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"documento" => "simple-article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Clin Invest Ginecol Obstet. 2003;30:185-90" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 9359 "formatos" => array:3 [ "EPUB" => 39 "HTML" => 5992 "PDF" => 3328 ] ] "es" => array:9 [ "idiomaDefecto" => true "titulo" => "El cerclaje de urgencia en la incompetencia istimicocervical con membranas protruyentes. nuestra experiencia" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "185" "paginaFinal" => "190" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.J. Carazo, R. Serna, D.E. Del carpio" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M.J." "apellidos" => "Carazo" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Serna" ] 2 => array:2 [ "nombre" => "D.E." "apellidos" => "Del carpio" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210573X03772566?idApp=UINPBA00004N" "url" => "/0210573X/0000003000000006/v1_201307111216/S0210573X03772566/v1_201307111216/es/main.assets" ] "es" => array:11 [ "idiomaDefecto" => true "titulo" => "Distrofia miotónica de steinert y gestación" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "191" "paginaFinal" => "195" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "M.A. Barber, I. Eguiluz, W. Plasencia, O. Ramírez" "autores" => array:4 [ 0 => array:3 [ "nombre" => "M.A." "apellidos" => "Barber" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "Eguiluz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "W." "apellidos" => "Plasencia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "O." "apellidos" => "Ramírez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Servicio de Obstetricia y Ginecología. Hospital Universitario Materno-Infantil de Canarias. Las Palmas de Gran Canaria. España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2003-05-29" "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Myotonic dystrophy is an unusual entity, which is rarely associated with pregnancy due to the fact that those people who are affected usually present with genital atrophy and hypogonadism. It is a neuro-endocrine «inherit-degenerative» dystrophy, with dominant autosomic transmission. Its association with pregnancy can lead to different problems. The myotony often worsens and obstetric complications increase; miscarriage, preterm delivery, hydrops fetalis, intrauterine death, difficulties in expulsion, intra and post partum haemorrhage. Signs of fetal affectation during pregnancy are hydrops, hydramnios, a reduction in fetal movements, and a slow fetal heart rate. Familial antecedents, severe hypotony or respiratory distress in the neonate are suggestive of the congenital form of myotonic dystrophy. The congenital form has a poor prognosis, and is more difficult to diagnose. Today, molecular genetic techniques allow to make both prenatal and an early neonatal diagnosis.</p>" ] "en" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La distrofia miotónica es una entidad infrecuente, raramente asociada a la gestación debido a que las personas afectadas suelen presentar atrofia genital con hipogonadismo. Se trata de una distrofia neuroendocrina heredodegenerativa, con transmisión autosómica dominante. Su asociación con el embarazo produce diferentes alteraciones: agravamiento de la miotonía y aumento de las complicaciones obstétricas, como un incremento de la tasa de abortos, un parto prematuro, hidrops fetal, muerte intrauterina, expulsivo prolongado, hemorragias intraparto o posparto, etc. Los signos que orientan a una afección fetal durante la gestación son: hidrops, hidramnios, disminución de los movimientos fetales y enlentecimiento del ritmo cardíaco, y los que sugieren una distrofia miotónica en su variante congénita son: antecedentes familiares, hipotonía grave o distrés respiratorio grave.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La variante congénita tiene un peor pronóstico y un diagnóstico más difícil. Actualmente, las técnicas de genética molecular permiten la realización de un diagnóstico prenatal y neonatal precoz de la enfermedad.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:53 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Miopatías hereditarias, metabólicas, endocrinas y tóxicas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.R. Mendel" 1 => "R.C. Griggs" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Harrison. Principios de medicina interna" "paginaInicial" => "2749" "paginaFinal" => "2769" "serieFecha" => "1994" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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año/Mes | Html | Total | |
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2024 Noviembre | 9 | 1 | 10 |
2024 Octubre | 70 | 9 | 79 |
2024 Septiembre | 75 | 22 | 97 |
2024 Agosto | 70 | 16 | 86 |
2024 Julio | 71 | 14 | 85 |
2024 Junio | 90 | 28 | 118 |
2024 Mayo | 85 | 16 | 101 |
2024 Abril | 67 | 24 | 91 |
2024 Marzo | 72 | 32 | 104 |
2024 Febrero | 74 | 19 | 93 |
2024 Enero | 83 | 28 | 111 |
2023 Diciembre | 109 | 36 | 145 |
2023 Noviembre | 129 | 42 | 171 |
2023 Octubre | 133 | 22 | 155 |
2023 Septiembre | 63 | 19 | 82 |
2023 Agosto | 40 | 27 | 67 |
2023 Julio | 52 | 11 | 63 |
2023 Junio | 60 | 13 | 73 |
2023 Mayo | 95 | 6 | 101 |
2023 Abril | 78 | 21 | 99 |
2023 Marzo | 68 | 6 | 74 |
2023 Febrero | 57 | 14 | 71 |
2023 Enero | 58 | 21 | 79 |
2022 Diciembre | 49 | 18 | 67 |
2022 Noviembre | 56 | 26 | 82 |
2022 Octubre | 53 | 34 | 87 |
2022 Septiembre | 48 | 13 | 61 |
2022 Agosto | 38 | 20 | 58 |
2022 Julio | 38 | 20 | 58 |
2022 Junio | 35 | 38 | 73 |
2022 Mayo | 32 | 15 | 47 |
2022 Abril | 31 | 10 | 41 |
2022 Marzo | 52 | 14 | 66 |
2022 Febrero | 33 | 13 | 46 |
2022 Enero | 95 | 27 | 122 |
2021 Diciembre | 60 | 13 | 73 |
2021 Noviembre | 75 | 16 | 91 |
2021 Octubre | 52 | 22 | 74 |
2021 Septiembre | 40 | 29 | 69 |
2021 Agosto | 63 | 14 | 77 |
2021 Julio | 53 | 18 | 71 |
2021 Junio | 28 | 8 | 36 |
2021 Mayo | 54 | 24 | 78 |
2021 Abril | 130 | 62 | 192 |
2021 Marzo | 71 | 11 | 82 |
2021 Febrero | 59 | 17 | 76 |
2021 Enero | 55 | 25 | 80 |
2020 Diciembre | 50 | 13 | 63 |
2020 Noviembre | 56 | 10 | 66 |
2020 Octubre | 37 | 17 | 54 |
2020 Septiembre | 45 | 39 | 84 |
2020 Agosto | 33 | 18 | 51 |
2020 Julio | 41 | 15 | 56 |
2020 Junio | 27 | 8 | 35 |
2020 Mayo | 34 | 16 | 50 |
2020 Abril | 16 | 8 | 24 |
2020 Marzo | 33 | 24 | 57 |
2020 Febrero | 32 | 10 | 42 |
2020 Enero | 44 | 19 | 63 |
2019 Diciembre | 62 | 54 | 116 |
2019 Noviembre | 48 | 13 | 61 |
2019 Octubre | 32 | 14 | 46 |
2019 Septiembre | 51 | 21 | 72 |
2019 Agosto | 41 | 21 | 62 |
2019 Julio | 38 | 22 | 60 |
2019 Junio | 93 | 33 | 126 |
2019 Mayo | 225 | 99 | 324 |
2019 Abril | 77 | 38 | 115 |
2019 Marzo | 31 | 17 | 48 |
2019 Febrero | 31 | 11 | 42 |
2019 Enero | 26 | 16 | 42 |
2018 Diciembre | 22 | 21 | 43 |
2018 Noviembre | 34 | 26 | 60 |
2018 Octubre | 42 | 19 | 61 |
2018 Septiembre | 27 | 27 | 54 |
2018 Agosto | 18 | 31 | 49 |
2018 Julio | 16 | 12 | 28 |
2018 Junio | 27 | 24 | 51 |
2018 Mayo | 16 | 17 | 33 |
2018 Abril | 27 | 18 | 45 |
2018 Marzo | 12 | 10 | 22 |
2018 Febrero | 22 | 10 | 32 |
2018 Enero | 16 | 11 | 27 |
2017 Diciembre | 7 | 3 | 10 |
2017 Noviembre | 14 | 13 | 27 |
2017 Octubre | 25 | 12 | 37 |
2017 Septiembre | 20 | 4 | 24 |
2017 Agosto | 15 | 2 | 17 |
2017 Julio | 16 | 8 | 24 |
2017 Junio | 19 | 10 | 29 |
2017 Mayo | 24 | 12 | 36 |
2017 Abril | 19 | 4 | 23 |
2017 Marzo | 36 | 29 | 65 |
2017 Febrero | 26 | 3 | 29 |
2017 Enero | 28 | 4 | 32 |
2016 Diciembre | 40 | 7 | 47 |
2016 Noviembre | 98 | 9 | 107 |
2016 Octubre | 60 | 5 | 65 |
2016 Septiembre | 29 | 11 | 40 |
2016 Agosto | 18 | 3 | 21 |
2016 Julio | 41 | 1 | 42 |
2016 Junio | 76 | 6 | 82 |
2016 Mayo | 57 | 14 | 71 |
2016 Abril | 59 | 5 | 64 |
2016 Marzo | 52 | 9 | 61 |
2016 Febrero | 53 | 6 | 59 |
2016 Enero | 41 | 10 | 51 |
2015 Diciembre | 40 | 10 | 50 |
2015 Noviembre | 68 | 7 | 75 |
2015 Octubre | 96 | 7 | 103 |
2015 Septiembre | 45 | 3 | 48 |
2015 Agosto | 70 | 3 | 73 |
2015 Julio | 109 | 3 | 112 |
2015 Junio | 62 | 3 | 65 |
2015 Mayo | 87 | 9 | 96 |
2015 Abril | 61 | 13 | 74 |
2015 Marzo | 106 | 3 | 109 |
2015 Febrero | 115 | 4 | 119 |
2015 Enero | 52 | 4 | 56 |
2014 Diciembre | 82 | 4 | 86 |
2014 Noviembre | 60 | 5 | 65 |
2014 Octubre | 56 | 4 | 60 |
2014 Septiembre | 62 | 3 | 65 |
2014 Agosto | 58 | 1 | 59 |
2014 Julio | 52 | 12 | 64 |
2014 Junio | 43 | 6 | 49 |
2014 Mayo | 21 | 2 | 23 |
2014 Abril | 26 | 2 | 28 |
2014 Marzo | 38 | 2 | 40 |
2014 Febrero | 34 | 1 | 35 |
2014 Enero | 25 | 2 | 27 |
2013 Diciembre | 32 | 2 | 34 |
2013 Noviembre | 28 | 4 | 32 |
2013 Octubre | 36 | 5 | 41 |
2013 Septiembre | 30 | 4 | 34 |
2013 Agosto | 29 | 6 | 35 |
2013 Julio | 28 | 1 | 29 |
2003 Mayo | 876 | 0 | 876 |