Notas clínicas
Transfusión fetofetal y complicaciones cardiovasculares
Twin-twin transfusion syndrome and cardiovascular complications
P. Betrián Blasco
, J. Girona Comas, D.C. Albert Brotons
Corresponding author
pedrobetrian@yahoo.es
Correspondencia: Dr. P. Betrián Blasco. Fraga, 18, 3.° C. 50003 Zaragoza. España.
Correspondencia: Dr. P. Betrián Blasco. Fraga, 18, 3.° C. 50003 Zaragoza. España.
Servicio de Cardiología Pediátrica. Hospital Maternoinfantil Vall d’Hebron. Barcelona. España
Read
10282
Timeswas read the article
3291
Total PDF
6991
Total HTML
Share statistics
array:23 [ "pii" => "S1695403305702563" "issn" => "16954033" "doi" => "10.1016/S1695-4033(05)70256-3" "estado" => "S300" "fechaPublicacion" => "2005-12-01" "aid" => "70256" "copyright" => "Asociación Española de Pediatría" "copyrightAnyo" => "2005" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2005;63:551-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5858 "formatos" => array:3 [ "EPUB" => 70 "HTML" => 5063 "PDF" => 725 ] ] "itemSiguiente" => array:18 [ "pii" => "S1695403305702575" "issn" => "16954033" "doi" => "10.1016/S1695-4033(05)70257-5" "estado" => "S300" "fechaPublicacion" => "2005-12-01" "aid" => "70257" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2005;63:555-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 12438 "formatos" => array:3 [ "EPUB" => 85 "HTML" => 9687 "PDF" => 2666 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Notas clínicas</span>" "titulo" => "Ileítis terminal por <span class="elsevierStyleItalic">Yersinia enterocolitica</span> en lactantes" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "555" "paginaFinal" => "557" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Terminal ileitis due to <span class="elsevierStyleItalic">Yersinia enterocolitica</span> in infants" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Sojo Aguirre, J. Álvarez Pitti, E. Morteruel Arizkuren, S. García González, I. Ruiz Manzanal, J.M. Arginzoniz Marzana, M. Labayru Echeverría" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Sojo Aguirre" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Álvarez Pitti" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Morteruel Arizkuren" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "García González" ] 4 => array:2 [ "nombre" => "I." "apellidos" => "Ruiz Manzanal" ] 5 => array:2 [ "nombre" => "J.M." "apellidos" => "Arginzoniz Marzana" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Labayru Echeverría" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403305702575?idApp=UINPBA00005H" "url" => "/16954033/0000006300000006/v1_201307051457/S1695403305702575/v1_201307051457/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1695403305702551" "issn" => "16954033" "doi" => "10.1016/S1695-4033(05)70255-1" "estado" => "S300" "fechaPublicacion" => "2005-12-01" "aid" => "70255" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2005;63:548-50" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 5554 "formatos" => array:3 [ "EPUB" => 87 "HTML" => 4850 "PDF" => 617 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Notas clínicas</span>" "titulo" => "Espasmos infantiles como primera manifestación de la acidemia propiónica" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "548" "paginaFinal" => "550" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Infantile spasms as the first manifestation of propionic acidemia" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Aldamiz-Echevarría Azuar, J.M. Prats Viñas, P. Sanjurjo Crespo, J.A. Prieto Perera, M.ªT. Labayru Echeverría" "autores" => array:5 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Aldamiz-Echevarría Azuar" ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Prats Viñas" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Sanjurjo Crespo" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Prieto Perera" ] 4 => array:2 [ "nombre" => "M.ªT." "apellidos" => "Labayru Echeverría" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403305702551?idApp=UINPBA00005H" "url" => "/16954033/0000006300000006/v1_201307051457/S1695403305702551/v1_201307051457/es/main.assets" ] "es" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Notas clínicas</span>" "titulo" => "Transfusión fetofetal y complicaciones cardiovasculares" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "551" "paginaFinal" => "554" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P. Betrián Blasco, J. Girona Comas, D.C. Albert Brotons" "autores" => array:3 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Betrián Blasco" "email" => array:1 [ 0 => "pedrobetrian@yahoo.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Girona Comas" ] 2 => array:2 [ "nombre" => "D.C." "apellidos" => "Albert Brotons" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Cardiología Pediátrica. Hospital Maternoinfantil Vall d’Hebron. Barcelona. España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Dr. P. Betrián Blasco. Fraga, 18, 3.° C. 50003 Zaragoza. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Twin-twin transfusion syndrome and cardiovascular complications" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2004-12-31" "fechaAceptado" => "2005-08-31" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186300" "palabras" => array:4 [ 0 => "Miocardiopatía" 1 => "Hipertrofia" 2 => "Síndrome de transfusion fetofetal" 3 => "Embarazo gemelar" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186299" "palabras" => array:4 [ 0 => "Cardiomyopathy" 1 => "Hypertrophy" 2 => "Twin-twin transfusion syndrome" 3 => "Twin pregnancy" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">El síndrome de transfusión fetofetal presenta una importante morbimortalidad, en parte debida a las alteraciones cardiovasculares que genera.</p> <span class="elsevierStyleSectionTitle">Casos clínicos</span><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Paciente 1</span>. Se realiza cesárea en la semana 28 por disfunción miocárdica e insuficiencia tricuspídea grave en el feto receptor. A las 12 h de vida, el feto receptor desarrolla un shock refractario. Se objetiva hipertrofia biventricular grave, que acaba en fallecimiento a las 60 h de vida en fallo multiorgánico.</p><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Paciente 2</span>. Se practica cesárea en la semana 29 por cardiomegalia e insuficiencia cardíaca congestiva. Al nacer presenta mala perfusión periférica e hipertensión. Se objetiva hipertrofia biventricular que progresa hasta generar una estenosis medioventricular derecha ligera a las 72 h. Se inicia regresión al octavo día y persiste ligera hipertrofia a los 6 meses.</p> <span class="elsevierStyleSectionTitle">Discusión</span><p class="elsevierStyleSimplePara elsevierViewall">Las alteraciones cardíacas en el síndrome de transfusion fetofetal aparecen sólo en los fetos receptores. Los hallazgos más frecuentes son la existencia de dilatación, hipertrofia, disfunción miocárdica, insuficiencia tricuspídea y estenosis pulmonar. Estas alteraciones suelen regresar con los meses, pudiendo también empeorar.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Twin-twin transfusion syndrome carries high morbidity and mortality, related in part to the cardiovascular alterations that it produces.</p> <span class="elsevierStyleSectionTitle">Case report</span><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Patient 1</span> underwent a cesarian section at week 28 due to myocardial dysfunction and severe tricuspid regurgitation in the recipient twin. Twelve hours after birth the recipient twin developed refractory shock. Severe biventricular hypertrophy was observed and the twin died 60 hours after birth from multisystemic failure.</p><p class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">Patient 2</span> underwent a cesarian section at week 29 due to cardiomegaly and cardiac insufficiency in the recipient twin. At birth, he showed hypertension and poor peripheral perfusion. Biventricular hypertrophy was observed, which increased until it produced a mild right midventricular stenosis at 72 hours, decreasing after the 8th day. Mild hypertrophy persisted at 6 months of life.</p> <span class="elsevierStyleSectionTitle">Discussion</span><p class="elsevierStyleSimplePara elsevierViewall">Cardiovascular alterations appear only in recipient fetuses affected by twin-twin transfusion syndrome. The most frequent findings are cardiac dilation, hypertrophy, myocardial dysfunction, tricuspid regurgitation and pulmonary stenosis. These alterations usually disappear during the first few months of life, but may also worsen.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antenatal factors at diagnosis that predict outcome in twin-twin transfusion syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.JO. Taylor" 1 => "M.L. Denbow" 2 => "K.R. Duncan" 3 => "T.G. Overton" 4 => "N.M. Fisk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1067/mob.2000.107368" "Revista" => array:6 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "2000" "volumen" => "183" "paginaInicial" => "1023" "paginaFinal" => "1028" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11035357" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Perinatal morbidity and mortalitiy rates in severe twin-twin transfusion syndrome: Results of the International Amnioreduction Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Mari" 1 => "A. Roberts" 2 => "L. Detti" 3 => "E. Kovanci" 4 => "T. Stefos" 5 => "R.O. Bahado-Sing" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1067/mob.2001.117188" "Revista" => array:6 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "2001" "volumen" => "185" "paginaInicial" => "708" "paginaFinal" => "715" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11568802" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acquired right ventricular outflow tract obstruction in the recipient twin in twin-twin transfusion syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Lougheed" 1 => "B.G. Sinclair" 2 => "K. Fung Kee Fung" 3 => "J.L. Bigras" 4 => "G. Ryan" 5 => "J.F. Smallhorn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2001" "volumen" => "38" "paginaInicial" => "1533" "paginaFinal" => "1538" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11691536" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Twin-twin transfusion syndrome. The influence of intrauterine laser photocoagulation on arterial distensibility in childhood" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.M. Gardiner" 1 => "M.J.O. Taylor" 2 => "A. Karatza" 3 => "T. Vanderheyden" 4 => "A. Huber" 5 => "S.E. Greenwald" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/01.CIR.0000060543.64250.80" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2003" "volumen" => "107" "paginaInicial" => "1906" "paginaFinal" => "1911" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12665487" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Influence of twin-twin transfusion syndrome on fetal cardiovascular structure and function: prospective casecontrol study of 136 monochorionic twin pregnancies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.A. Karatza" 1 => "J.L. Wolfenden" 2 => "M.J.O. Taylor" 3 => "L. Wee" 4 => "N.M. Fisk" 5 => "H.M. Gardiner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Heart" "fecha" => "2002" "volumen" => "88" "paginaInicial" => "271" "paginaFinal" => "277" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12181221" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathogenesis of twin-twin transfusion syndrome: the renin-angiotensin system hypothesis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Mahieu-Caputo" 1 => "F. Muler" 2 => "D. Joly" 3 => "M.C. Gubler" 4 => "J. Lebidois" 5 => "L. Fermont" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "53919" "Revista" => array:6 [ "tituloSerie" => "Fetal Diagn Ther" "fecha" => "2001" "volumen" => "16" "paginaInicial" => "241" "paginaFinal" => "244" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11399888" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natriuretic peptides in the pathogenesis of cardiac dysfunction in the recipient fetus of twin-twin transfusion syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Bajoria" 1 => "S. Ward" 2 => "R. Chatterjee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "2002" "volumen" => "186" "paginaInicial" => "121" "paginaFinal" => "127" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11810097" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Syndrome transfuseur-tranfusé: complications hémodynamiques à propos de deux observations" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Mareschal-Desandes" 1 => "J.M. Hascoët" 2 => "G. Bosser" 3 => "F. Marçon" 4 => "F. Didier" 5 => "A. Miton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Pédiatr" "fecha" => "2002" "volumen" => "9" "paginaInicial" => "377" "paginaFinal" => "381" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11998423" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Twin-twin transfusion syndrome: A five year review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y.C. Seng" 1 => "V.S. Rajadurai" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Dis Child Fetal Neonatal Ed" "fecha" => "2000" "volumen" => "83" "paginaInicial" => "168" "paginaFinal" => "170" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal hypertension: An insight into the pathogenesis of the twin-twin transfusion syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Mahieu-Caputo" 1 => "L.J. Salomon" 2 => "J. Le Bidois" 3 => "L. Fermont" 4 => "P. Jouvet" 5 => "Y. Dumez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/pd.652" "Revista" => array:6 [ "tituloSerie" => "Prenat Diagn" "fecha" => "2003" "volumen" => "23" "paginaInicial" => "640" "paginaFinal" => "645" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12913870" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cardiac dysfunction in twin-twin transfusion syndrome: a prospective, longitudinal study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.L. Simpson" 1 => "G.R. Marx" 2 => "E.A. Elkadry" 3 => "M.E. D’Alton" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Obstet Gynecol" "fecha" => "1998" "volumen" => "92" "paginaInicial" => "557" "paginaFinal" => "562" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9764628" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Myocardial hypertrophy of the recipient twins in twin-twin transfusion syndrome and cerebral palsy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H.M. Hyodo" 1 => "N. Unno" 2 => "H. Masuda" 3 => "T. Watanabe" 4 => "S. Kozuma" 5 => "Y. Taketani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Int J Gynaecol Obstet" "fecha" => "2003" "volumen" => "80" "paginaInicial" => "29" "paginaFinal" => "34" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12527457" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary stenosis in recipient twins in twin-to-twin transfusion syndrome: report on 3 cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Murakoshi" 1 => "K. Yamamori" 2 => "Y. Tojo" 3 => "H. Naruse" 4 => "M. Seguchi" 5 => "Y. Torii" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Croat Med J" "fecha" => "2000" "volumen" => "41" "paginaInicial" => "252" "paginaFinal" => "256" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10962042" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fetal and neonatal echocardiographic findings in twin-twin transfusion syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Fesslova" 1 => "L. Villa" 2 => "S. Nava" 3 => "F. Mosca" 4 => "U. Nicolini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Obstet Gynecol" "fecha" => "1998" "volumen" => "179" "paginaInicial" => "1056" "paginaFinal" => "1062" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9790398" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and echocardiographic features of in utero cardiac dysfunction in the recipient twin in twin-twin transfusion syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Zosmer" 1 => "R. Bajoria" 2 => "E. Weiner" 3 => "M. Rigby" 4 => "J. Vaughan" 5 => "N.M. Fisk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br Heart J" "fecha" => "1994" "volumen" => "72" "paginaInicial" => "74" "paginaFinal" => "79" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8068474" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary artery calcification in recipient twins of twin to twin transfusion sydrome: A report a three cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Saxena" 1 => "N.R. Soni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00246-001-0067-2" "Revista" => array:6 [ "tituloSerie" => "Pediatr Cardiol" "fecha" => "2003" "volumen" => "24" "paginaInicial" => "80" "paginaFinal" => "83" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12574984" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/16954033/0000006300000006/v1_201307051457/S1695403305702563/v1_201307051457/es/main.assets" "Apartado" => array:4 [ "identificador" => "14441" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Notas clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/16954033/0000006300000006/v1_201307051457/S1695403305702563/v1_201307051457/es/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403305702563?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 9 | 23 | 32 |
| 2024 October | 53 | 77 | 130 |
| 2024 September | 57 | 63 | 120 |
| 2024 August | 55 | 113 | 168 |
| 2024 July | 36 | 63 | 99 |
| 2024 June | 42 | 66 | 108 |
| 2024 May | 49 | 64 | 113 |
| 2024 April | 39 | 51 | 90 |
| 2024 March | 31 | 65 | 96 |
| 2024 February | 30 | 52 | 82 |
| 2024 January | 26 | 57 | 83 |
| 2023 December | 27 | 35 | 62 |
| 2023 November | 23 | 40 | 63 |
| 2023 October | 26 | 31 | 57 |
| 2023 September | 22 | 25 | 47 |
| 2023 August | 20 | 28 | 48 |
| 2023 July | 35 | 55 | 90 |
| 2023 June | 26 | 63 | 89 |
| 2023 May | 30 | 29 | 59 |
| 2023 April | 22 | 13 | 35 |
| 2023 March | 24 | 36 | 60 |
| 2023 February | 18 | 20 | 38 |
| 2023 January | 26 | 27 | 53 |
| 2022 December | 39 | 31 | 70 |
| 2022 November | 41 | 45 | 86 |
| 2022 October | 26 | 65 | 91 |
| 2022 September | 24 | 46 | 70 |
| 2022 August | 40 | 70 | 110 |
| 2022 July | 78 | 51 | 129 |
| 2022 June | 28 | 50 | 78 |
| 2022 May | 32 | 43 | 75 |
| 2022 April | 28 | 51 | 79 |
| 2022 March | 35 | 48 | 83 |
| 2022 February | 23 | 33 | 56 |
| 2022 January | 34 | 49 | 83 |
| 2021 December | 26 | 60 | 86 |
| 2021 November | 27 | 60 | 87 |
| 2021 October | 34 | 71 | 105 |
| 2021 September | 27 | 67 | 94 |
| 2021 August | 19 | 37 | 56 |
| 2021 July | 29 | 44 | 73 |
| 2021 June | 30 | 51 | 81 |
| 2021 May | 31 | 33 | 64 |
| 2021 April | 67 | 98 | 165 |
| 2021 March | 56 | 63 | 119 |
| 2021 February | 55 | 48 | 103 |
| 2021 January | 41 | 41 | 82 |
| 2020 December | 55 | 42 | 97 |
| 2020 November | 21 | 35 | 56 |
| 2020 October | 18 | 32 | 50 |
| 2020 September | 13 | 14 | 27 |
| 2020 August | 23 | 11 | 34 |
| 2020 July | 22 | 18 | 40 |
| 2020 June | 15 | 16 | 31 |
| 2020 May | 48 | 13 | 61 |
| 2020 April | 44 | 14 | 58 |
| 2020 March | 57 | 10 | 67 |
| 2020 February | 48 | 23 | 71 |
| 2020 January | 15 | 21 | 36 |
| 2019 December | 43 | 31 | 74 |
| 2019 November | 21 | 7 | 28 |
| 2019 October | 10 | 20 | 30 |
| 2019 September | 13 | 12 | 25 |
| 2019 August | 33 | 21 | 54 |
| 2019 July | 22 | 44 | 66 |
| 2019 June | 19 | 29 | 48 |
| 2019 May | 33 | 20 | 53 |
| 2019 April | 34 | 45 | 79 |
| 2019 March | 17 | 16 | 33 |
| 2019 February | 16 | 11 | 27 |
| 2019 January | 12 | 18 | 30 |
| 2018 December | 16 | 19 | 35 |
| 2018 November | 27 | 25 | 52 |
| 2018 October | 39 | 30 | 69 |
| 2018 September | 16 | 15 | 31 |
| 2018 July | 3 | 0 | 3 |
| 2018 June | 2 | 0 | 2 |
| 2018 May | 2 | 0 | 2 |
| 2018 April | 10 | 0 | 10 |
| 2018 March | 3 | 0 | 3 |
| 2018 February | 5 | 0 | 5 |
| 2018 January | 3 | 0 | 3 |
| 2017 December | 7 | 0 | 7 |
| 2017 November | 8 | 0 | 8 |
| 2017 October | 7 | 0 | 7 |
| 2017 September | 10 | 0 | 10 |
| 2017 August | 8 | 0 | 8 |
| 2017 July | 6 | 0 | 6 |
| 2017 June | 13 | 24 | 37 |
| 2017 May | 15 | 17 | 32 |
| 2017 April | 14 | 20 | 34 |
| 2017 March | 11 | 28 | 39 |
| 2017 February | 11 | 13 | 24 |
| 2017 January | 10 | 10 | 20 |
| 2016 December | 14 | 8 | 22 |
| 2016 November | 26 | 10 | 36 |
| 2016 October | 33 | 14 | 47 |
| 2016 September | 42 | 14 | 56 |
| 2016 August | 23 | 4 | 27 |
| 2016 July | 14 | 5 | 19 |
| 2016 March | 3 | 0 | 3 |
| 2016 February | 1 | 6 | 7 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 1 | 0 | 1 |
| 2015 November | 2 | 0 | 2 |
| 2015 October | 3 | 0 | 3 |
| 2015 September | 3 | 0 | 3 |
| 2015 August | 0 | 11 | 11 |
| 2015 July | 9 | 0 | 9 |
| 2015 June | 8 | 1 | 9 |
| 2015 May | 13 | 0 | 13 |
| 2015 April | 11 | 5 | 16 |
| 2015 March | 22 | 0 | 22 |
| 2015 February | 15 | 9 | 24 |
| 2015 January | 9 | 4 | 13 |
| 2014 December | 23 | 4 | 27 |
| 2014 November | 23 | 2 | 25 |
| 2014 October | 20 | 4 | 24 |
| 2014 September | 24 | 3 | 27 |
| 2014 August | 31 | 3 | 34 |
| 2014 July | 48 | 2 | 50 |
| 2014 June | 43 | 5 | 48 |
| 2014 May | 50 | 6 | 56 |
| 2014 April | 39 | 1 | 40 |
| 2014 March | 50 | 8 | 58 |
| 2014 February | 45 | 15 | 60 |
| 2014 January | 40 | 13 | 53 |
| 2013 December | 37 | 9 | 46 |
| 2013 November | 29 | 5 | 34 |
| 2013 October | 44 | 8 | 52 |
| 2013 September | 34 | 11 | 45 |
| 2013 August | 41 | 11 | 52 |
| 2013 July | 28 | 5 | 33 |
| 2013 June | 3 | 2 | 5 |
| 2013 May | 2 | 2 | 4 |
| 2013 April | 5 | 1 | 6 |
| 2013 March | 4 | 2 | 6 |
| 2013 February | 11 | 1 | 12 |
| 2013 January | 22 | 0 | 22 |
| 2012 December | 12 | 0 | 12 |
| 2012 November | 6 | 0 | 6 |
| 2012 October | 2 | 1 | 3 |
| 2012 September | 2 | 1 | 3 |
| 2005 December | 3526 | 0 | 3526 |
Show all
