Nice wg 4000 инструкция pdf

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Despite initial enthusiasm about the utility of balloon catheter occlusion, available data are unclear regarding its efficacy. Recommendations and Conclusions Women at greatest risk of placenta accreta are those who have myometrial damage caused by an earlier cesarean delivery with either an anterior or posterior placenta previa overlying the uterine scar. Prophylactic antibiotics are indicated, with repeat doses after 2–3 hours of surgery or 1,500 mL of estimated blood loss. Although most studies have suggested comparable diagnostic accuracy of MRI and ultrasonography for placenta accreta, MRI is considered an adjunctive modality and adds little to the diagnostic accuracy of ultrasonography. Generally, planned attempts at manual placental removal should be avoided. If hysterectomy becomes necessary, the standard approach is to leave the placenta in situ, quickly use a “whip stitch” to close the hysterotomy incision, and proceed with hysterectomy. Nike currently manufactures two Nike+ devices that offer a time-of-day display.

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