简介:AbstractThe pathophysiology of twin-to-twin transfusion syndrome (TTTS) is complex, and its understanding has evolved along with the evolution and revolution of fetal diagnostic and therapeutic techniques. Over the last few decades, several therapeutic interventions have been researched for improving the outcomes in TTTS. We present a summary of the current protocols for surveillance, diagnosis, and staging of TTTS in monochorionic pregnancies. We also describe in detail the technique for treatment of TTTS by endoscopic laser photocoagulation.
简介:AbstractThe rate of twin pregnancies has increased over the last decades, largely because of the ongoing development of assisted reproductive technology and increased maternal age at childbearing. Twins have a higher risk of adverse outcomes during pregnancy and the perinatal period. The prevalence of umbilical cord abnormalities is higher for twin pregnancies compared with singleton pregnancies. Some of these abnormalities are nonspecific to twinning and can also be found in singleton gestations (such as velamentous cord insertion, vasa previa, and single umbilical artery). Other abnormalities are associated with monochorionic twins, such as umbilical cord entanglement, and umbilical proximate cord insertion. Most of these abnormalities can be detected by ultrasound evaluation. The early and accurate ultrasound diagnosis of chorionicity, amnionicity, and placental and umbilical cord characteristics is crucial if we are to predict the risk of complications and to determine the best management for twin pregnancies. Histopathological examination of the placenta and umbilical cord after delivery can help to confirm prenatal diagnosis and to provide a better understanding of the physiopathology of their abnormalities. The aim of this review was to emphasize the role that the umbilical cord plays in twin complications and to describe the management of these high-risk pregnancies.
简介:AbstractMode of delivery in twin gestation has been a matter of debate for decades. In 2013, the only randomized controlled trial concerning mode of delivery in twin gestations was published, answering some of the most pressing questions in this matter. The Twin Birth Study randomized patients carrying dichorionic-diamniotic or monochorionic-diamniotic twins, with the first twin in cephalic presentation, between 32 and 39 weeks of gestation, to planned vaginal vs. planned cesarean delivery, and found no significant differences in perinatal or maternal outcomes. These clinical findings greatly benefit our clinical practice, but there lacks related study investigating how the practices have changed. In this review, we searched PubMed from 1980 through January 2021 using combinations of the following terms: twin, delivery, vaginal delivery, and cesarean section. We will try to address the known literature before and after the publication of the Twin Birth Study in western countries and compare that to what has been practiced in China.
简介:Thewavetransmissioncharacteristicsandwaveinducedpressuresontwinplatebreakwaterareinvestigatedexperimentallyinregularandrandomwaves.Atotaloftwentypressuretransducersarefixedonfoursurfacesoftwinplatetomeasurethewaveinduceddynamicpressures.Thespatialdistributionofdynamicwavepressureisgivenalongthesurfaceofthetwinplate.Theupliftwaveforceobtainedbyintegratingthehydrodynamicpressurealongthestructureispresented.DiscussedaretheinfluenceofdifferentincidentwaveparametersincludingtherelativeplatewidthB/L,relativewaveheight/iHaandrelativesubmergencedepths/aonthenon-dimensionaldynamicwavepressuresandtotalwaveforces.Fromtheinvestigation,itisfoundthattheoptimumtransmissioncoefficient,tKoccursaroundB/L0.41~0.43,andthetwinplatebreakwaterismoreeffectiveindifferentwaterdepths.Themaximumofpressureratiodecreasesfrom1.8to1.1whentherelativesubmergencedepthoftopplateisincreasedfrom0.8to+0.8.
简介:Withthickplatesof2219high-strengthalloy,themicrostructuresofweldedjointswithtwinwireMIGweldingwereanalyzed.Experimentalresultsshowthatnohotcrackwasfoundintheweldduetodiscontinuousdistributionofcocrystallizationwithlowmeltingtemperature,butporosityisseriousinthefirstweldseamthatismainlycomposedofequiaxialgrainswithunevensizes.Asthepoorpositionofthewholeweldedjoint,fusionzonehasbigandcoarsegrains,unevenmicrostructures;Inquenchingzone,thereexistalotofsoakedmicrostructuresthatcocrystallizationwithlowmeltingtemperaturesoluteintomatrix,thusstrengtheningthemetalinthiszone;Inexcessiveagingzone,muchmorephasesthatdistributeevenlywillbeseparatedfromthematrix;Outsidethiszone,propertiesandmicrostructuresofthemetalarebasicallysimilartomatrixduetotherelativelylowtemperatureorunaffectedheatinthezoneduringwelding.
简介:ColdMetalTransfer(CMT)weldingtechniqueisanewweldingtechniqueintroducedbyFroniuscompany.CMTweldingofnickel-basedalloywithstainlesssteelwascarriedoutusingCuSi3fillerwireinthispaper.Effectsofweldingparameters,includingweldingcurrent,weldingspeed,etc,onweldsurfaceappearanceweretested.MicrostructureandmechanicalpropertiesofCMTweldwerestudied.Theresultsshowthatthethicknessofinterfacereactionlayerofthenickel-basedalloyis14.3μm,whichisonly4.33%ofbasematerial.Theweldismadeupoftwophases,α-copperandiron-basedsolidsolution.Ruptureoccursinitiallyattheweldedseamneartheedgeofstainlesssteelinsheartest.ThemaximumshearstrengthoftheCuSi3weldedjointis184.9MPa.