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A TIPS procedure decreases the effective vascular resistance of the liver through the creation of an alternative pathway for portal venous circulation. By creating a shunt from the portal vein to the hepatic vein, this intervention allows portal blood an alternative avenue for draining into systemic circulation.
Both TIPS and portacaval shunting effectively reduce portal pressure but share the risk of hepatic encephalopathy (HE) due to bypassing the liver's detoxification process. In TIPS, HE symptoms can often be managed by adjusting the stent, whereas portacaval shunting provides a permanent solution without the ability to make such adjustments.
Where cardiac arrest occurs in a pregnant woman, irrespective of the condition of the fetus, the procedure should be performed immediately if basic and advanced life support attempts are proving unsuccessful at achieving return of spontaneous circulation, and the woman's uterus is deemed capable of causing aortocaval compression.
A hysterotomy is performed on the pregnant woman, and once the uterus is open and the fetus is exposed, the fetal surgery begins. Typically, this surgery consists of an interim procedure intended to allow the fetus to remain in utero until it has matured enough to survive delivery and neonatal surgical procedures.
A transjugular intrahepatic portosystemic shunt (TIPS) is a procedure an interventional radiologist performs to create a shunt (essentially, a new conduit allowing for blood flow) between the hepatic inferior vena cava and the portal vein, a vessel that returns blood from the intestines to the liver.
In some cases, the amniotic sac may also be broken if the mother can feel the sac bulging, and is feeling pressure in her vagina due to this. There is no good evidence as of 2014 regarding if antibiotics before the procedure affects outcomes. [4]
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Components of this often include informed consent, anesthesia evaluation, and a pregnancy test (as current pregnancy is a contraindication to the procedure). All patients will undergo endometrial sampling to test for endometrial carcinoma, as this is an absolute contraindication to endometrial ablation.
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