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Resumen OBJETIVO: Identificar la coexistencia de anticuerpos contra la proteína "Spike" del SARS-CoV-2 en sangre del cordón umbilical de recién nacidos de madres vacunadas contra la COVID-19 durante el embarazo. MATERIALES Y MÉTODOS: Estudio transversal, llevado a cabo en un centro de atención privada de la Ciudad de México, entre junio del 2021 y febrero del 2022, al que se incluyeron mujeres que completaron el esquema de vacunación contra SARS-CoV-2 durante el embarazo y en quienes en el trascurso de la finalización del embarazo parto o cesárea se haya obtenido una muestra de sangre de cordón umbilical para identificar la proteína Spike. RESULTADOS: Se registraron 219 pacientes y se analizaron 5 tipos de vacuna de dos plataformas diferentes; Pfizer®, Moderna®, AstraZeneca®, J&J/Janssen® y Sputnik®. La concentración de anticuerpos fue mayor en pacientes vacunadas con Moderna® y Sputnik®. Mediante el análisis de regresión de Cox se evaluó un modelo predictivo, sin mostrar diferencia estadísticamente significativa en la cantidad de anticuerpos generados luego de la primera y segunda dosis de la vacuna. CONCLUSIONES: La vacunación prenatal contra la COVID-19 induce una fuerte respuesta humoral materna, que se transfiere de manera efectiva al feto, incluso con una sola dosis.

Abstract OBJECTIVE: Identification of the presence of SARS-CoV-2 Spike protein antibodies in cord blood of newborns following maternal COVID-19 vaccination during pregnancy. MATERIALS AND METHODS: Cross-sectional study in vaccinated women during pregnancy who had a cord blood sample taken during the surgical procedure Vaginal birth/Cesarean section to measure spike protein antibodies. RESULTS: We registered 219 patients in the study: five types of vaccines, from two different platforms, were tested: Pfizer®, Moderna®, AstraZeneca®, J&J/Janssen® and Sputnik®. The levels of antibodies were greater in those patients vaccinated with Moderna® and Sputnik®. Through a Cox regression we made a predictive model where we observed that there are no differences in the number of antibodies generated after the first and second vaccine dose. CONCLUSIONS: Prenatal vaccination against COVID-19 induces a strong maternal humoral response that is effectively transferred to the fetus, even with a single dose.

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Laparoscopic myomectomy offers a real benefit to infertile patients with uterine fibroids and peritoneal adhesions. The procedure requires a skilled surgeon and laparoscopy technique to minimize adhesion formation and other proven benefits. Restrictions arise since this procedure requires power morcellation for fibroid tissue extraction. Two years ago, the Food and Drug Administration in the United States of America (FDA) issued the alert on power morcellation for uterine leiomyomas, addressing the risk of malignant cell spreading within the abdominal cavity (actual risk assessment from 1 in 360 to 1 in 7400 cases). We review a 30-year-old female, without previous gestations, hypermenorrhea, intermenstrual bleeding, and chronic pelvic pain. Transvaginal ultrasound reports multiple fibroids in the right portion of a bicornuate uterus. Relevant history includes open myomectomy 6 years before and a complicated appendectomy, developing peritonitis within a year. Laparoscopy revealed multiple adhesions blocking uterine access, a bicornuate uterus, and myomas in the expected site. Myomectomy was performed utilizing power morcellation with good results. FDA recommendations have diminished this procedure's selection, converting many to open variants. This particular case was technically challenging, requiring morcellation, and safety device deployment was impossible, yet the infertility issue was properly addressed. Patient evaluation, safety measures, and laparoscopy benefits may outweigh the risks in particular cases as this one.