We performed an impact study on the introduction of routine placement of internal iliac artery balloon catheters for the management of haemorrhage during caesarean section in women with placenta accreta. We identified 11 women, with prenatally diagnosed placenta accreta/increta/percreta before this change in practice, who acted as controls, and 30 women who had iliac artery balloons placed. The balloons were inflated in 27 cases. The median (IQR [range]) intra-operative blood loss was 1100 (800-2600 [500-6000]) ml in controls, compared with 1000 (600-2513 [400-15000]) ml in women with iliac artery balloons (p = 0.64). Six (54%) controls received intra-operative blood transfusion compared with 14 (47%) women with iliac artery balloons (p = 0.66). Caesarean hysterectomy was performed in 3 (27.3%) controls and 13 (43.3%) women with iliac artery balloons (p = 0.48). Balloon catheter insertion was associated with a shortened postoperative hospital stay, 6 (5-7 [4-12] days in controls vs. 5 (4-6 [3-10]) in the iliac artery balloon group (p = 0.033). General anaesthesia was used in six (54%) controls, but all women with iliac artery balloons. This study demonstrates that prophylactic balloon occlusion of the internal iliac arteries did not reduce intra-operative haemorrhage or caesarean hysterectomy in women with placenta accreta undergoing caesarean section. In addition, it has a significant impact on the choice of anaesthetic technique.
The Reactive Force Field (ReaxFF) is a powerful computational tool for exploring material properties. In this work, we proposed an enhanced reactive force field model, which using Message Passing Neural...
Using density-functional linear-response theory, we calculated the phonon dispersion curves for the diamond structural elemental semiconductors of Ge, C and zinc-blende structure semiconductors of GaAs, InSb at different electronic temperatures. We found that the transverse-acoustic phonon frequencies of C and Ge become imaginary as the electron temperature is elevated, which means the lattices of C and Ge become unstable under intense laser irradiation. These results are very similar with previous theoretical and experimental results for Si. For GaAs and InSb, not only can be obtained the similar results for their transverse-acoustic modes, but also their LO-TO splitting gradually decreases as the electronic temperature is increased. It means that the electronic excitation weakens the strength of the ionicity of ionic crystal under intense laser irradiation.
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