Regístrese
¿Aún no está registrado?
Información relevante

Consulte los artículos y contenidos publicados en este medio, además de los e-sumarios de las revistas científicas en el mismo momento de publicación

Máxima actualización

Esté informado en todo momento gracias a las alertas y novedades

Promociones exclusivas

Acceda a promociones exclusivas en suscripciones, lanzamientos y cursos acreditados

Crear Mi cuenta
Buscar en
Clínica e Investigación en Ginecología y Obstetricia
Toda la web
Inicio Clínica e Investigación en Ginecología y Obstetricia Parálisis del plexo braquial como traumatismo obstétrico
Información de la revista
Vol. 28. Núm. 6.Enero 2001
Páginas 213-260
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 28. Núm. 6.Enero 2001
Páginas 213-260
DOI: 10.1016/S0210-573X(01)77098-0
Acceso a texto completo
Parálisis del plexo braquial como traumatismo obstétrico
Visitas
21188
L.C. Tejerizo-Lópeza, F.J. Monleón-Sancho*,a, A. Tejerizo-Garcíaa, F.J. Monleón-Alegre*,a
* Departamento de Obstetricia y Ginecología. Hospital Universitario La Fe. Valencia. España.
a Servicio de Obstetricia y Ginecología. Hospital Virgen de la Vega. Salamanca. España.
Este artículo ha recibido
21188
Visitas
Información del artículo
Resumen
Bibliografía
Descargar PDF
Estadísticas
Resumen

La parálisis obstétrica del plexo braquial es el traumatismo obstétrico más frecuente después de la fractura de clavícula, y consiste en un traumatismo o lesión por elongación del plexo braquial en el momento del parto.

Summary

The obstetrical paralysis of the brachial plexus is the most frequent obstetric traumatism after the clavicle fracture and it is due to a traumatism or injury caused by elongation of the brachial plexus at the moment of the birth.

El Texto completo solo está disponible en PDF
Bibliografía
[1.]
I. Claret Corominas
Traumatismos fetales
Tratado de Obstetricia Dexeus. II. Pa-tología Obstétrica, pp. 745-762
[2.]
M.C. Romaña
La paralysie obstétricale du plexus brachial
J Gynecol Obstet Biol Reprod, 29 (2000), pp. 33-35
[3.]
J. Monleón Alegre,J. Monleón Sancho,R. Sánchez Sánchez,L.C. Tejerizo López,A. Teijelo Déiros,J. Mínguez Sanz
Traumatismos obstétricos
Manual de asistencia al parto y puerperio patológicos, pp. 453-471
[4.]
H. Martius
Heridas obstétricas
Tratado de obstetricia, 4, pp. 620-628
[5.]
H. Ewerbeck
Situaciones de urgencia por parte del feto. Complicaciones extrauterinas posparto
Gi-necología y obstetricia (II). Embarazo y parto, pp. 793-822
[6.]
F.G. Cunningham,P.C. MacDonald,N.F. Gant,K.J. Leveno,LC III Gilstrap,G.D.V. Hankins
Enfermedades y lesiones del feto y el recién nacido
Williams obstetricia, 20, pp. 901-939
[7.]
I.S. Salonen,R. Uüsitalo
Birth injuries: incidence and predisposing factors
Zeitschr für Kinderch, 45 (1990), pp. 133-139
[8.]
W.L. Oppenhein,A. Davis,W.A. Growdon,F.J. Dorey,L.B. Davlin
Clavicle fracture in the newborn
Clin Orthop, 250 (1990), pp. 176-181
[9.]
N.Y. Boo,M.S. Lye,M. Kanchanamala,C.L. Ching
Plexus brachial injuries in Malasyan neonates: Incidence and associate risk factors
J Trop Pediatr, 37 (1991), pp. 327-332
[10.]
E.S. Tank,R. Davis,F. Holt,G.W. Morley
Mechanism of trauma during breech delivery
Obstet Gynecol, 38 (1971), pp. 761-766
[11.]
J.B. De Meeus,M. Deshayes,G. Magnin
Dystocie par excé de volume fetal
Encly Méd Chir Obstétrique, pp. 5067-A-10
[12.]
J.Y. Grall,J. Dubois,P.Y. Moquet,P. Poulain,J. Blanchot,M.C. Laurent
Presentation du siège
Encly Méd Chir Obs-tétrique, pp. 5049-L-40
[13.]
G. Magnin,F. Pierre
Dystocie des épaules
Encycl Méd Chir Gynecologie 5-5067-A-10,
[14.]
R.B. Gherman,J.G. Ouzounian,T.M. Goodwin
Obstetric maneuvers for shoulder dystocia and associated fetal morbidity
Am J Obstet Gynecol, 178 (1998), pp. 1126-1130
[15.]
K.R. Lipscomb,K. Gregory,K. Shaw
The outcome of ma-crosomic infants at least 4500 grams: Los Angeles county+ University of Southern California Experience
Obstet Gynecol, 85 (1995), pp. 558-564 http://dx.doi.org/10.1016/0029-7844(95)00005-C
[16.]
G. Berard,P. Dufour,D. Vinatier,D. Subtil,S. Vanderstichele,J.C. Monnier
Fetal macrosomia: risk factors and ou-tome. A study of the outcome concerning 100 cases > 4.500 g
Eur J Obstet Gynecol Reprod Biol, 77 (1998), pp. 51-59
[17.]
D.B. Acker,B.P. Sachs,P.A. Fiedman
Risk factors for shoulder dystocia
Obstet Gynecol, 66 (1965), pp. 762-765
[18.]
O. Langer,M.D. Berkys,R.W. Huff,A. Samueloff
Shoulder dystocia: should the fetus weighting ≥?4000 g be delivery by cesarean section?
Am J Obstet Gynecol, 165 (1991), pp. 831-837
[19.]
J.J. Nocon,D.K. McKenzie,L.J. Thomas,R.S. Hansell
Shoulder dystocia: An analysis of risks and obstetric maneuvers
Am J Obstet Gynecol Obstet, 168 (1993), pp. 1.732-1.733
[20.]
L.B. Kolderup,R.K. Laros,T.J. Lyscu
Incidence of persistent birth injury in macrosomic infants: association with mode of delivery
Am J Obstet Gynecol, 177 (1997), pp. 37-40
[21.]
T.S. Nesbitt,W.M. Gilbert,B. Herrchen
Shoulder dystocia and associated risk factors with macrosomic infants born in California
Am J Obstet Gynecol, 179 (1998), pp. 476-480
[22.]
D.R. Bryant,M.R. Leonard,J.B. Landwehr,S.F. Bottoms
Limited usefulness of fetal weight in preciding neonatal brachial plexus injury
Am J Obstet Gynecol, 179 (1998), pp. 689-699
[23.]
M. Gordon,H. Rich,J. Deutchberger,M. Green
The immediate and long term outcome of obstetric birth trauma. 1Brachial plexus paralysis
Am J Obstet Gynecol, 171 (1971), pp. S1-S5
[24.]
R.H. Allen,B.R. Bankoski,C.A. Butzin,D.A. Nagey
Comparing clinician applied loads for routine, difficult, and shoulder dystocia deliveries
Am J Obstet Gynecol, 171 (1994), pp. 1621-1627
[25.]
T. Walle,A.L. Hartikainen-Sorri
Obstetric shoulder injury: Associated risk factors, prediction and prognosis
Acta Obstet Gynecol Scand, 72 (1993), pp. 450-454
[26.]
B.B. Bager
Perinatally acquired brachial plexus palsy. A persisting challenge
Acta Paediatr, 86 (1997), pp. 1214-1219
[27.]
F.G. Cunningham,P.C. McDonald,N.F. Gant,K.J. Leveno,LC III Gilstrap,G.D.V. Hankins
Macrosomía
Williams obste-tricia, 20, pp. 797-801
[28.]
T.F. Baskett,A.C. Allen
Perinatal implications of shoulder dystocia
Obstet Gynecol, 86 (1995), pp. 14-17 http://dx.doi.org/10.1016/0029-7844(95)00099-D
[29.]
M.H. Beall,C. Spong,J. Makay,M.G. Ross
Objective definition of shoulder dystocia: A prospective evaluation
Am J Obstet Gynecol, 179 (1998), pp. 934-937
[30.]
H.F. Sadmire
Whiter ultrasonic prediction of fetal macro-somia?
Obstet Gynecol, 82 (1993), pp. 860-865
[31.]
W.N. Spellacy,M.S. Miller,A. Winegar,P.Q. Peterson
Ma-crosomia –maternal characteristics and infant complications
Obstet Gynecol, 66 (1985), pp. 158-163
[32.]
H. Modanlou,W. Dorchester,A. Thorosian,R. Freeman
Macrosomia: maternal, fetal and neonatal implications
Obstet Gynecol, 55 (1980), pp. 240-244
[33.]
B. Cohen,S. Penning,C. Major,D. Ansley,M. Porto,T. Garite
Sonographic prediction of shoulder dystocia in infants of diabethic mothers
Obstet Gynecol, 88 (1996), pp. 10-13 http://dx.doi.org/10.1016/0029-7844(96)00067-1
[34.]
T. Benedetti,S. Gabbe
Shoulder dystocia
Obstet Gynecol, 52 (1978), pp. 526-529
[35.]
M. McFarland,M. Hod,J.M. Piper,E.M. Xenakis,O. Langer
Are labor abnormalities more common in shoulder dysto-cia?
Am J Obstet Gynecol, 173 (1996), pp. 1211-1214
[36.]
D.M. Sherer,M. Menashe,Z. Palti,I. Aviad,M. Ron
Radiologic evidence for a nuchal arm in the breech-presenting fetus at the onset of labor: an indication for abdominal delivery
Am J Perinatol, 6 (1989), pp. 353-355 http://dx.doi.org/10.1055/s-2007-999613
[37.]
J. Dubois
Aspects actuels des problèmes que pose l’accou-chement en presentation du siége
J Gynecol Obstet Biol Reprod, 10 (1981), pp. 479-492
[38.]
J. Dubois,E. Fraisse
Le siège aujourd’hui
Conc Med, 104 (1982), pp. 7219-7226
[39.]
G.D.V. Hankins,S.L. Clark
Brachial plexus palsy involving the posterior shoulder at spontaneous vaginal delivery
Am J Perinatol, 12 (1995), pp. 44-50 http://dx.doi.org/10.1055/s-2007-994398
[40.]
R.J. Jennett,T.J. Tarby,C.J. Kreinick
Brachial plexus palsy: An old problem revisited
Am J Obstet Gynecol, 166 (1992), pp. 1673-1687
[41.]
R. Gonen,D. Spiegel,M. Abend
Is macrosomia predictable and are shoulder dystocia and birth trauma preventable?
Obstet Gynecol, 88 (1996), pp. 526-529
[42.]
F. Goffinet
Les difficultés de la reconnaissance anténatale de la macrosomie foetale
J Gynecol Obstet Biol. Reprod, 2 (2000), pp. 13-19
[43.]
H.C. Ong,D.K. Sen
Clinical estimation of fetal weight
Am J Obstet Gynecol, 112 (1972), pp. 877-880
[44.]
R.M. Patterson
Estimation of fetal weight during labor
Obstet Gynecol, 65 (1985), pp. 330-332
[45.]
G.I. Hirata,A.L. Medearis,J. Horenstein,M.B. Bear,L.D. Platt
Ultrasonographic estimation of fetal weight in the clinically macrosomic fetus
Am J Obstet Gynecol, 162 (1990), pp. 238-242
[46.]
S.P. Chauhan,P.M. Lutton,K.J. Bailey,J.P. Guerini,J.C. Morrison
Intrapartum clinical, sonographic, and parous patients’ estimates of newborn birth weight
Obstet Gynecol, 79 (1992), pp. 956-958
[47.]
J.P. Elliott,T.J. Garite,R.K. Freeman,D.S. McQuown,J.M. Patel
Ultrasonic prediction of fetal macrosomia in diabetic patients
Obstet Gynecol, 60 (1982), pp. 159-162
[48.]
F.P. Hadlock
Sonographic estimation of fetal age and weight
Radiol Clin North Am, 28 (1990), pp. 39-50
[49.]
R.A. McLaren,J.L. Puckett,S.P. Chauhan
Estimators of birth weight in pregnant women requiring insulin: a comparison of seven sonographic models
Obstet Gynecol, 85 (1995), pp. 565-569 http://dx.doi.org/10.1016/0029-7844(94)00454-L
[50.]
O.M. Alsulyman,J.G. Ouzonian,S.L. Kjos
The accuracy of intrapartum ultrasonographic fetal weight estimation in diabetic pregnancy
Am J Obstet Gynecol, 177 (1997), pp. 503-506
[51.]
B.R. Benacerraf,R. Gelman,FD Jr. Frigoletto
Sonographi-cally estimated fetal weights: accuracy and limitation
Am J Obstet Gynecol, 159 (1988), pp. 1118-1121
[52.]
D.N. Platek,M.Y. Divon,A. Anyaegbunam,J.R. Merkatz
In-trapartum ultrasonographic estimates of fetal weight by the house staff
Am J Obstet Gynecol, 165 (1991), pp. 842-845
[53.]
H.L. Hedriana,T.R. Moore
A comparison of single versus multiple growth ultrasonographic examinations in predicting birth weight
Am J Obstet Gynecol, 170 (1994), pp. 1600-1604
[54.]
N.T. Field,J.M. Piper,O. Langer
The effect of maternal obesity on the accuracy of fetal weight estimation
Obstet Gy-necol, 86 (1995), pp. 102-107
[55.]
W.J. Watson,A.P. Soisson,F.E. Harlass
Estimated weight of the term fetus. Accuracy of ultrasound vs clinical examination
J Reprod Med, 33 (1988), pp. 369-371
[56.]
S. Raman,R. Urquhart,M. Yusof
Clinical versus ultrasound estimation of fetal weight
Aust NZ Obstet Gynae-col, 32 (1992), pp. 196-199
[57.]
S.P. Chauhan,N.W. Hendrix,E.F. Magann,J.C. Morrison,S.P. Kenney,L.D. Devoe
Limitations of clinical and sono-graphic estimation of birth weight: experience with 1034 parturients
Obstet Gynecol, 91 (1998), pp. 72-77
[58.]
R.B. Smith,C. Lane,J.F. Pearson
Shoulder dystocia: what happens at the nest delivery?
Br J Obstet Gynecol, 101 (1994), pp. 713-715
[59.]
M. Geary,P. McParland,H. Johnson,J. Stronge
Shoulder dystocia –is it predictable?
Eur J Obstet Gynecol Reproduc Biol, 62 (1995), pp. 15-18
[60.]
E. Verspyck,F. Goffinet,M. Hellot,J. Milliez,L. Marplau
Newborn shoulder width: a prospective study a 2222 consecutive measurements
Br J Obstet Gynecol, 106 (1999), pp. 589-593
[61.]
A.M. Bahah
Risk factors and fetal outcome in cases of shoulder dystocia compared with normal deliveries of a similar birthweight
Br J Obstet Gynaecol, 103 (1996), pp. 868-872
[62.]
HG Jr. Hopwood
Shoulder dystocia: fifteen years’s experience in a community hospital
Am J Obstet Gynecol, 144 (1982), pp. 162-166
[63.]
H.N. Winn,W. Holcomb,J.B. Shumway,A. Al-Malt,E. Amon,J.C. Hobbins
The neonatal bisacromial diameter: a pre-natal sonographic evaluation
J Perinat Med, 25 (1997), pp. 484-487
[64.]
A. Riska,H. Laine,P. Voutilainen,V. Kariniemi
Estimation of fetal shoulder width by measurement of the humerospi-nous distance by ultrasound
Ultrasound Obstet Gynecol, 7 (1996), pp. 272-274 http://dx.doi.org/10.1046/j.1469-0705.1996.07040272.x
[65.]
B. Kastler,A. Gangi,C. Mathelin
Fetal shoulder measurements with RMI
J Comput Assist Tomogr, 17 (1993), pp. 777-780
[66.]
F. Bonnel
Anatomie du plexus brachial chez le nouveau-né et l’adulte (structures macroscopique et histologique
Monographies du Group d’Étude de la Main, pp. 3-13
[67.]
A. Gilbert,N. Khouri,H. Carlioz
Exploration chirurgicale du plexus brachial dans la paralysie obstétricale. Constatations anatomiques chez 21 malades opérés
Rev Chir Ort-hop, 66 (1980), pp. 33-42
[68.]
M. Camus,D. Vauthier,G. Lefebvre,P. Veron,P. Darbois
Etude rétrospective de 33 paralysies obstétricale du plexus brachial. Gynecol Obstet Biol
Reprod, 17 (1988), pp. 220-228
[69.]
J.P. Métaizeau
Les paralysies obstétricales du plexus brachial
Cahiers d’enseignement de la SOFCOT, 3 (1993), pp. 109-124
[70.]
G. Gentjens,A. Gilbert,K. Helsen
Obstetric brachial plexus palsy associated with breech delivery
J Bone Joint Surg, 78 (1996), pp. 303-306
[71.]
R. Elert
Bases para las indicaciones, técnicas y peligros de los partos operatorios (inducción del parto, cesárea, fór-ceps, vacuoextracción
Ginecología y obste-tricia (II). Embarazo y parto, pp. 952-996
[72.]
E. Andreres
Lehrbuch der geburts chilflichen Operationen
[73.]
H. Stamm,E.N. Florek
Curso y conducción del parto en las presentaciones atípicas y patológicas
Gineco-logía y obstetricia (II). Embarazo y parto, pp. 533-538
[74.]
J. Mallafré,X. Serrat
Distocia de causa fetal
Tratado de obstetricia Dexeus (II).Patología obstétrica, pp. 533-583
[75.]
S.A. Sunderland
Classification or peripheral injuries producing loss of function
Brain, 74 (1951), pp. 491-516
[76.]
I.M. Golditch,K. Kirkman
The large fetus management and outcome
Obstet Gynecol, 52 (1978), pp. 26-30
[77.]
C. Ouarda,A. Marzouk,L. Ben Youssef,M. Chelli
Le pro-nostic neonatal et maternal d’accouchement d’un gros foetus unique à terme. A propos de 497 cas
J Gynecol Obstet Biol Reprod, 18 (1989), pp. 360-366
[78.]
P. Panel,J.B. De Meeus,B. Yanoulopoulos,M. Deshayes,G. Accouchement du gros enfant. Magnin
Conduite á tenir et résultats à propos de 198 dossiers
J Gynecol Obstet Biol Reprod, 20 (1991), pp. 199-204
[79.]
J.M. Ubachs,A.C. Sloof,L.L. Peeters
Obstetric antecedents of surgically treated obstetric brachial plexus injuries
Br J Obstet Gynaecol, 105 (1995), pp. 813-817
[80.]
J.L. Tassin
Paralyses obstétricales du plexus brachial.Evolution spontanée, resultants des interventions répara-trices précoces
Thèse doctoral,
[81.]
A. Gilbert,R. Brockman,H. Carlioz
Surgical treatment of brachial plexus palsy
Clin Orthop, 264 (1991), pp. 39-47
[82.]
ACJ. Sloof
Obstetrical brachial plexus lesions and their neurosurgical treatment
Clin Neurol Neurosurg, 95 S (1993), pp. 73-77
[83.]
I. Alfonso,O. Papazan,J.A. Grossman
Clinical presentations, differential diagnosis and management of obstetric palsy
Rev Neurol, 27 (1998), pp. 258-263
[84.]
V. Forin,C. Romaña
Paralysie obstétricale du plexus brachial. Kinésitherapie-Rééducation Fonctionelle 26-473-A-10
Encycl Méd Chir,
[85.]
D.J. Rouse,J. Owen,R.L. Goldenberg,S.P. Cliver
The effectiveness and costs of elective cesarean delivery for fetal macrosomia diagnosed by ultrasound
JAMA, 276 (1996), pp. 1480-1486
[86.]
E.H. Delpapa,E. Mueller-Euloach
Pregnancy outcome following ultrasound diagnosis of macrosomia
Obstet Gyne-col, 78 (1991), pp. 340-343
[87.]
J.W. Weeks,T. Pitman,J.A. Spinnato
Fetal macrosomia: does antenatal prediction affect delivery route and birth outcome?
Am J Obstet Gynecol, 173 (1995), pp. 1215-1219
[88.]
A.B. Levine,C.J. Lockwood,B. Brown,R. Lapinski,R.L. Berko-witz
Sonographic diagnosis of the large for gestational age fetus at term: does it make a difference?
Obstet Gyne-col, 79 (1992), pp. 55-58
[89.]
C.A. Combs,N.B. Singh,J.C. Khoury
Elective induction versus spontaneous labor after sonographic diagnosis of fetal macrosomia
Obstet Gynecol, 81 (1993), pp. 492-496
[90.]
D.L. Conway,O. Langer
Elective delivery of infants with macrosomia in diabetic women: reduced shoulder dystocia versus increased cesarean deliveries
Am J Obstet Gynecol, 178 (1998), pp. 922-925
[91.]
P. Hope,S. Breslin,L. Lamont
Fatal shoulder dystocia: a review of 56 cases reported to the Confidential Enquiry into Stillbirths and Deaths in Infancy
Br J Obstet Gynecol, 105 (1998), pp. 1256-1261
[92.]
Y. Malinas
Dystocie des épaules, une minute pour surviv-re
La practique médical quotidienne, 211 (1985), pp. 8-15
[93.]
C. Wood,K.H. Ng,D. Hounslow,H. Benning
Time: an important variable in normal delivery
J Obstet Gynecol Br Commonw, 80 (1973), pp. 295-300
[94.]
J.F. Oury,O. Sibony,D. Luton,O. Feran,J.L. Voluménie,P. Blot
Stratégies obstétricales et conduites d’urgence dans l’accouchement du macrosome
J Gynecol Obstet Biol Re-prod, 29 (2000), pp. 20-24
[95.]
R. Allen,J. Sorat,B. Gonik
Risk factors for shoulder dystocia: an engineering study of clinician-applied forces
Obs-tet Gynecol, 77 (1991), pp. 352-356
[96.]
F. Beguin
La dystocie des épaules: ne tirez pas
Bull Péri-natol (Géneve), 14 (1990), pp. 2-6
[97.]
J.A. O’Leary,H.B. Leonetti
Shoulder dystocia: prevention and treatment
Am J Obstet Gynecol, 162 (1990), pp. 5-9
[98.]
G. Magnin
L’accouchement du gross enfant
Pratique de l’accouchement, 3, pp. 149-171
[99.]
O. Gregoriou,A. Maragoudakis,K. Papadias,S. Konidaris,P. Zourlas
La dystocie des épaules
J Gynecol Obstet Biol. Reprod, 18 (1989), pp. 255-261
[100.]
C. Sureau
Notions nouevelles sur l’anatomie et la physiologie de l’articulation sacro-iliaque
Press Med, 23 (1959), pp. 947-948
[101.]
R. Merger,J. Levy,J. Melchior
Précis d’obstétrique
[102.]
P. Kamina
Anatomie gynécologique et obstétricale
4,
[103.]
J.M. Thoulon,C. Welffen-Ekfra,P. Arnould,P. Andra
Étude anatomoclinique et radiologique du basin obstetrical
Encycl Méd Chir Gynécologique/Obstétrique, pp. 5007-5010
[104.]
B. Gonik,R. Allen,J. Sorab
Objetive evaluation of the shoulder dystocia phenomenon: effect of maternal pelvic orientation on force reduction
Obstet Gynecol, 74 (1989), pp. 44-84
[105.]
J.P. Schaal,R. Maillet,C. Gay,C. Colette
La disproportion foetopelvienne
Mise à jour en Gynécologie et obstétrique,
[106.]
M. Dumont
La longue et laborieuse naissance de la Symphysétoomie ou de Séverin Pineau à Jean-René Si-gault
J Gynecol Obstet Biol Reprod, 18 (1989), pp. 11-21
[107.]
J.A. O’Leary
Cephalic replacement for shoulder dystocia: present status and future role of the Zavanelli maneuver
Obstet Gynecol, 82 (1993), pp. 847-850
[108.]
M. Van Lierde
La dystocie des épaules
J Gynecol Obstet Biol Reprod, 18 (1989), pp. 127-133
[109.]
R.P. Perkins
Distocias fetales
Clin Obst Gin. México: Inte-ramericana, 30 (1987), pp. 53-62
[110.]
RW III Naef,JN Jr. Martin
Tratamiento urgente de la dis-tocia de hombros. Clin Gin Obst. Temas actuales
México, Interamericana, 22 (1995), pp. 231-242
[111.]
C.L. Cetrulo,L.C. Cetrulo
Aspectos medicolegales de las distocias. Clin Obst Gin
México, Interamericana, 30 (1987), pp. 101-107
[112.]
T.L. Gross,R.J. Sokol,T. Williams,K. Thompson
Shoulder dystocia: a fetal-physician risk
Am J Obstet Gynecol, 156 (1987), pp. 1408-1418
Copyright © 2001. Elsevier España, S.L.
es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos