two occasions: (i) from December 2011 to May 2012, for a pregnancy classified as high-risk, which ended with a caesarean section at 32 weeks, and (ii) from March 2013 to date, for a second pregnancy, which, at this time, is in approximately the twentysixth week”; ix) “The said medical records reveal that: (i) the patient [B.] suffers from SLE with discoid, rheumatoid arthritis, and lupus nephritis symptoms; (ii) during her second pregnancy she has suffered from infections, pulmonary problems and arterial hypertension that, according to the diagnoses and evaluations contained in her medical records, reveal that, as her pregnancy progresses, the patient may suffer from a worsening of the SLE and the above-mentioned obstetric complications, and these symptoms are aggravated by the fetal anencephaly, which would cause other problems, and (iii) with medical assistance and treatment, the patient’s health has improved significantly, to the extent that it is now stable”; x) “The report of the Latin American Center for Perinatology, Women and Reproductive Health of the Pan-American Health Organization incorporated into these proceedings, indicates that the physiological changes inherent in a pregnancy may accelerate and exacerbate the illness of [B.] and even cause a series of obstetric complications that already occurred in her first pregnancy, including preeclampsia. Added to this, it indicates that it should be recalled that the patient suffers from lupus nephritis; namely, one of the highest causes of mortality in pregnant women with SLE”; xi) “Another factor that should be considered in the case of [B.] is the anencephaly – absence of cranium and brain – of the fetus that she is carrying, because this congenital malformation, incompatible with life outside the uterus, is associated with a series of obstetric-maternal complications, such as disseminated intravascular coagulation”; xii) “According to the declaration of the Head of the Perinatology Service of the National Maternity Hospital, in the twenty-sixth week, the physiological changes of pregnancy provoke hypervolemia, in other words, an increase in the volume of blood accompanied by changes in coagulation, such that during this period the patient may experience the problems referred to previously, which she experienced in the twentyeighth week of her first pregnancy”; xiii) “Regarding the medical care that the petitioner received when she was transferred to the National Maternity Hospital in March this year, there is sufficient evidence to conclude that the defendant officials provided [B.] with satisfactory medical assistance, because they were able to stabilize her health situation, providing her with treatment to control the lupus outbreak from which she was suffering”; xiv) “The said authorities decided to provide [B.] with the necessary medicines to stabilize her critical situation, avoiding complications to her health and imminent danger to her right to life or that of the unborn child. This action by the said authorities was in keeping with the conclusions of the appraisal of the Institute of Forensic Medicine, specifically the finding that, in the case examined, what was appropriate at that moment was that the patient should be kept under medical observation and treatment. Consequently, since the authorities of the National Maternity Hospital provided [B.] with the treatment that, according to medical science, guaranteed her rights to health and life, which consisted in hospitalizing her, constantly monitoring her health situation, and providing her with the necessary medicines to stabilize this, it is concluded that, at the specific moment of the presentation of the application and during this proceeding the said authorities have not committed the omission attributed to them and, consequently, the alleged violation of fundamental rights does not exist. Indeed, the patient survives 10

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