Parto gemelar diferido: a propósito de un caso / Delayed twin birth: case report

INTRODUCCIÓN: Se presenta el caso de un parto diferido en una gestación gemelar en la que se consigue retrasar el parto del segundo gemelo 45 días con manejo conservador. CASO CLÍNICO: Mujer de 25 años, gestación gemelar bicorial biamniótica, con diagnóstico de muerte fetal del primer gemelo en semana 24+3 y parto del mismo tras una semana de evolución. Se decide la opción de tratamiento conservador expectante, con reposo absoluto, manteniendo tocolisis intravenosa, controles analíticos seriados, controles cardiotocográficos diarios, profilaxis antibiótica y antitrombótica. Con ello se consigue diferir el parto un total de 45 días. CONCLUSIÓN: El parto diferido en gestaciones gemelares es una práctica poco habitual, por lo que se carece de protocolos y actuaciones específicas. La bibliografía disponible difiere en cuanto al manejo de dichos casos y en el total de días que se consigue diferir el parto, pero en todos los estudios se reporta el beneficio en términos de resultados perinatales al conseguir aumentar la edad gestacional del segundo gemelo. En nuestro caso se consiguió una mejora sustancial del resultado perinatal asociado a la prematuridad sin importantes efectos adversos maternos y tras el periodo de latencia indicado.

INTRODUCTION: We report a delayed delivery of a dichorionic diamniotic twin pregnancy, in which the birth of the second twin was postponed 45 days. CASE REPORT: At 24+3 weeks of gestation, a 25-year-old woman with dichorionic diamniotic twin pregnancy presented with preterm premature rupture of membranes and intrauterine dead of the first fetus. Spontaneous delivery of the first death twin, occurred al 25+2 weeks. Tocolysis, antibiotic, antithrombotic prophylaxis, absolute rest, serial blood tests and fetal cardiotocography controls, were performed. The second twin was delivered at 31+5 weeks, after a the preterm premature rupture of membranes triggered the labor. The interval between the first and second birth was 45 days. CONCLUSION: Delayed delivery in twin pregnancies, is an uncommon clinical situation, so there are not validated medical protocols. Available bibliography offers different practices related to its management. Most studies confirm the better survival rate and perinatal outcomes of the postponed birth twin.

Labeling of HeLa cells using ZrO2:Yb(3+)-Er(3+) nanoparticles with upconversion emission.

This work reports the synthesis, structural characterization, and optical properties of ZrO2:Yb(3+)-Er(3+) (2­1 mol%) nanocrystals. The nanoparticles were coated with 3-aminopropyl triethoxysilane (APTES) and further modified with biomolecules, such as Biotin-Anti-rabbit (mouse IgG) and rabbit antibody-AntiKi-67, through a conjugation method. The conjugation was successfully confirmed by Fourier transform infrared, zeta potential, and dynamic light scattering. The internalization of the conjugated nanoparticles in human cervical cancer (HeLa) cells was followed by two-photon confocal microscopy. The ZrO2:Yb(3+)-Er(3+) nanocrystals exhibited strong red emission under 970-nm excitation. Moreover, the luminescence change due to the addition of APTES molecules and biomolecules on the nanocrystals was also studied. These results demonstrate that ZrO2:Yb(3+)-Er(3+) nanocrystals can be successfully functionalized with biomolecules to develop platforms for biolabeling and bioimaging.