Gemelos Parápagos Dicéfalos: reporte de caso

Abstract

Background: Myelomeningocele is the most common neural tube defect; one case per 1000 live births is reported. It is more frequent in females, resulting in disabling sequelae, including urological sequelae. They can be corrected with different surgi- cal techniques and complex urological derivations that predispose them to repeated urinary tract infections and, when there is pregnancy, maternal-fetal complications and difficulty for surgical access, in case of cesarean section. Clinical case: Patient 14 weeks pregnant, 27 years old, diagnosed with myelome- ningocele and vesicoplasty, with multiple urinary tract infections and preterm rupture of membranes. Termination of pregnancy by cesarean section at 33 weeks, due to fetal conditions. The cesarean section technique was modified so as not to damage the cystoplasty and to avoid complications with adhesions in the pelvis. Conclusions: The best maternal-fetal prognosis in patients with complex urologic diversion is achieved with the intentional search for urinary tract infections and timely and adequate treatment, in addition to multidisciplinary planning at the time of ter- mination of pregnancy.