[
    {
        "page": 1,
        "title": "PLACENTA PREVIA",
        "body": "<div>\n\n<meta charset=\"utf-8\" \/><b style=\"font-weight:normal\" id=\"docs-internal-guid-a0092cc4-7fff-3641-1737-68bae8578f46\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">PLACENTA PREVIA<\/span><\/p><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">DEFINICI\u00d3N<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Implantaci\u00f3n anormal de la placenta en el segmento uterino inferior, de modo que cubre parcial o totalmente el orificio cervical interno (OCI).<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Se manifiesta t\u00edpicamente como <\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">sangrado vaginal indoloro en el segundo o tercer trimestre<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">CLASIFICACI\u00d3N (Ecogr\u00e1fica)<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Placenta previa total:<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> cubre completamente el OCI.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Placenta previa parcial:<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> cubre parcialmente el OCI.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Placenta marginal:<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> alcanza el borde del OCI, sin cubrirlo.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Placenta de inserci\u00f3n baja:<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> &lt;2 cm del OCI, sin alcanzarlo.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-style:italic;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Nota:<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> la clasificaci\u00f3n por tacto vaginal ha sido reemplazada por la ecograf\u00eda transvaginal, mucho m\u00e1s precisa.<\/span><\/p><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">EPIDEMIOLOG\u00cdA<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Incidencia general: ~0.5% de los embarazos.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Mayor frecuencia con aumento de ces\u00e1reas y procedimientos uterinos previos.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">FACTORES DE RIESGO<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Ces\u00e1rea previa (incremento proporcional al n\u00famero de ces\u00e1reas).<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Multiparidad.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Edad materna avanzada (&gt;35 a\u00f1os).<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Embarazo m\u00faltiple.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Tabaquismo.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Antecedente de placenta previa.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Legrados uterinos, cirug\u00eda uterina (miomectom\u00eda).<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">FISIOPATOLOG\u00cdA<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">El segmento uterino inferior se forma al final del segundo trimestre.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Si la placenta se inserta en esa regi\u00f3n, el adelgazamiento fisiol\u00f3gico de esa zona durante el tercer trimestre puede provocar <\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">despegue placentario parcial y sangrado<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">, incluso sin trabajo de parto.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">La formaci\u00f3n de vasos aberrantes y el trofismo vascular del \u00e1rea pueden contribuir a la hemorragia.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">MANIFESTACIONES CL\u00cdNICAS<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Sangrado vaginal rojo brillante<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">, s\u00fabito, recurrente, <\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">indoloro<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Com\u00fanmente en tercer trimestre.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Primer episodio a menudo autolimitado, pero puede repetirse y ser m\u00e1s severo.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">\u00datero blando, no doloroso.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Presentaci\u00f3n fetal an\u00f3mala (transversa o de nalga) por obstrucci\u00f3n del segmento inferior.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Palpaci\u00f3n de partes fetales elevada y dif\u00edcil.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">DIAGN\u00d3STICO<\/span><\/p><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Ecograf\u00eda<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Transvaginal:<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> m\u00e9todo de elecci\u00f3n. Precisa y segura.<\/span><\/p><\/li><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Courier New',monospace;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"2\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Permite medir la distancia entre el borde placentario y el OCI.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Courier New',monospace;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"2\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Puede realizarse incluso en presencia de sangrado.<\/span><\/p><\/li><\/ul><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Transabdominal:<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> menos sensible, puede subestimar la cercan\u00eda al OCI.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Ecograf\u00edas seriadas \u00fatiles en caso de inserci\u00f3n baja antes de las 28 semanas, ya que la placenta puede \u201cmigrar\u201d con el crecimiento uterino.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Tacto vaginal<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Contraindicado<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> hasta haber excluido placenta previa por ecograf\u00eda.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Si se requiere evaluaci\u00f3n manual, debe hacerse en quir\u00f3fano preparado para ces\u00e1rea.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">CONDUCTA SEG\u00daN CL\u00cdNICA Y EDAD GESTACIONAL<\/span><\/p><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Sin sangrado o sangrado leve<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Manejo ambulatorio o internaci\u00f3n breve.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Reposo relativo, sin relaciones sexuales ni tactos.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Control ecogr\u00e1fico a las 32 semanas.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Maduraci\u00f3n pulmonar con corticoides si &lt;34 semanas.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Con sangrado moderado o recurrente<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Hospitalizaci\u00f3n con monitorizaci\u00f3n materna y fetal.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Preparaci\u00f3n para posible parto prematuro.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Administraci\u00f3n de corticosteroides y neuroprotecci\u00f3n fetal si &lt;32 sem.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Hemorragia grave o sangrado persistente<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Ces\u00e1rea de urgencia, independientemente de la edad gestacional.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Reposici\u00f3n de volumen, hemoderivados seg\u00fan necesidad.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">CONSIDERACIONES PARA LA V\u00cdA DEL PARTO<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Ces\u00e1rea es la v\u00eda preferida<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> si la placenta cubre parcial o totalmente el OCI.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Se puede considerar parto vaginal solo si:<\/span><\/p><\/li><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Courier New',monospace;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"2\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">La placenta est\u00e1 a \u22652 cm del OCI.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Courier New',monospace;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"2\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">No hay sangrado activo.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Courier New',monospace;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"2\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Presentaci\u00f3n cef\u00e1lica.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Courier New',monospace;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"2\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Parto vigilado en centro especializado.<\/span><\/p><\/li><\/ul><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">CES\u00c1REA PLANIFICADA<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Programar entre las <\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">36-37 semanas<\/span><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\"> si la paciente est\u00e1 estable y no hay sangrado activo.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Requiere disponibilidad de banco de sangre.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Evaluar signos de placenta acreta si placenta previa + ces\u00e1rea previa.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">COMPLICACIONES<\/span><\/p><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Maternas<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Hemorragia masiva.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Necesidad de transfusi\u00f3n.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Histerectom\u00eda periparto (si hay placenta acreta).<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Riesgo de placenta acreta en embarazos futuros.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Infecci\u00f3n puerperal.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Riesgo aumentado de prematuridad en embarazos subsiguientes.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Fetales<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Prematuridad espont\u00e1nea o iatrog\u00e9nica.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">RCIU.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Presentaciones an\u00f3malas.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Mortalidad perinatal aumentada si no se maneja adecuadamente.<\/span><\/p><\/li><\/ul><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-weight:700;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">CONSEJER\u00cdA<\/span><\/p><ul style=\"margin-top:0;margin-bottom:0;padding-inline-start:48px\"><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Educar a la paciente sobre signos de alarma: sangrado, contracciones, p\u00e9rdida de l\u00edquido.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Evitar coito, tacto vaginal y ejercicios intensos si se diagnostica previa.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Reforzar necesidad de controles regulares y disponibilidad hospitalaria.<\/span><\/p><\/li><li dir=\"ltr\" style=\"list-style-type:disc;font-size:10pt;font-family:'Noto Sans Symbols',sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre\" aria-level=\"1\"><p dir=\"ltr\" style=\"line-height:1.3900000000000001;margin-bottom:8pt\" role=\"presentation\"><span style=\"font-size:12pt;font-family:Calibri,sans-serif;color:#000000;background-color:transparent;font-variant:normal;text-decoration:none;vertical-align:baseline;white-space:pre;white-space:pre-wrap\">Aconsejar ingreso hospitalario en casos de sangrados recurrentes o necesidad de vigilancia continua.<\/span><\/p><\/li><\/ul><\/b>\n<br \/><\/div>",
        "footer": "P\u00e1gina 1"
    }
]