Case 182

Patient, 32 years old, fourth pregnancy with three previous abortions, without comorbidities or complaints. Seeks obstetric evaluation due to history of multiple miscarriages, in which genetic studies have shown fetuses with normal karyotypes. Gestational age of 36 weeks, blood group A, Rh negative, BMI = 22, normoglycemic, susceptible to toxoplasmosis and unmarkable serology. On examination: blood pressure = 120x70mmHg, uterus fundus of 24cm, uterus' cervix was posterior, long and closed. Results from previous obstetrical ultrasound (Table 1).

Based on clinical history, laboratory tests, ultrasound and Doppler velocimetric evolution, which is the most likely diagnosis and the best therapeutic management?

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