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Interventional Radiology Procedure Shown to Preserve Uterus in Women with Placenta Accreta

By MedImaging International staff writers
Posted on 29 Dec 2014

Researchers reported that a procedure can preserve fertility and potentially save the lives of women with a serious pregnancy complication called placenta accreta. New findings revealed that the positioning of balloons in the main artery of the mother’s pelvis before a Cesarean section protects against hemorrhage and is safe for both mother and baby.

The findings of the new study were presented at the annual meeting of the Radiological Society of North America (RSNA), held November 30 to December 5, 2014, in Chicago (IL, USA). Placenta accreta, a disorder in which the placenta abnormally implants in the uterus, can lead to additional complications, including massive obstetric hemorrhage at delivery. Surgical removal of the uterus, called hysterectomy, is typically required to control such bleeding. “Massive obstetric hemorrhage is the number one cause of maternal mortality worldwide and abnormal placental implantation is a major risk factor for this,” said Patrick Nicholson, MB, BCh, an interventional radiologist trainee at Cork University Hospital (Cork, Ireland).

Patients with abnormal placental implantation at Dr. Nicholson’s hospital are treated by a multidisciplinary team that plans both an elective Caesarean (C-) section and prophylactic internal iliac balloon placement under fluoroscopic guidance. Immediately prior to the patient's C-section, an interventional radiologist uses specialized techniques to insert balloons into the two internal iliac arteries in the pelvis that supply the uterus with blood flow. “Following the delivery of the baby, these balloons can be inflated to slow blood flow to the uterus, which allows the obstetrician time to gain control of the hemorrhage,” Dr. Nicholson said.

For his study, Dr. Nicholson retrospectively reviewed the charts of all patients with abnormal placental implantation who received prophylactic internal iliac balloon placement since 2009. Over a 44-month period, the hospital treated 21 patients (mean age 35) who underwent balloon placement immediately followed by C-section. In 13 of the 21 deliveries, the arterial balloons were inflated and when no longer needed, deflated and removed from the patient. The interventional radiology procedure was a technical success in 100% of the cases. However, despite use of the balloons, two of the patients required a hysterectomy. “Without the balloons, many more of the patients would likely have required a hysterectomy,” Dr. Nicholson said.

There were no fetal or maternal complications resulting from the interventional procedure. “We are the first group to report on the fetal outcomes associated with prophylactic internal iliac artery balloon placement,” Dr. Nicholson said. “There were no adverse outcomes for the babies as a result of this procedure.”

According to Dr. Nicholson, the incidence of abnormal placental implantation has been increasing steadily over recent years. “The risks for placenta accreta and its variations increase with a woman’s age, earlier C-sections and in vitro fertilization, all of which we expect to see more of in the coming decades,” he said. “There’s clearly a need for more research in this field.”

Dr. Nicholson noted that the study’s findings add to a growing body of evidence that high-risk placental implantation pregnancies are best managed in a multidisciplinary setting. “This research highlights the value of interventional radiology in managing this very serious, high-risk condition to control bleeding and maternal and fetal complications,” Dr. Nicholson concluded.

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61 (!!!!! 5485.0578308105): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (!!!!! 2465.9633636475): SELECT fid FROM jos_deeppockets WHERE id=294756428 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294756428 AND published='1' LIMIT 1

63 (!!!!! 4296.0643768311): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

64 (!!!!! 2413.9881134033): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 3100.8720397949): select jos_facebook.link from jos_facebook where cat=10

66 (761.98577880859): select jos_google_plus.link from jos_google_plus where cat=10

67 (330.92498779297): select jos_linkedin.link from jos_linkedin where cat=10

68 (43.153762817383): SELECT fid FROM jos_deeppockets WHERE id=294756428 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294756428 AND published='1' LIMIT 1

69 (117.06352233887): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (!!!!! 1492.977142334): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (593.90068054199): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (61.988830566406): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (821.11358642578): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (95.844268798828): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (628.94821166992): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (386.95335388184): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (188.11225891113): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (154.97207641602): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (433.92181396484): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (!!!!! 3884.0770721436): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 4190.9217834473): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (54.121017456055): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (41.961669921875): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (!!!!! 1434.0877532959): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (650.16746520996): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (54.121017456055): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (!!!!! 3949.8805999756): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (98.943710327148): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3551.0063171387): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

105 (!!!!! 3840.9233093262): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

106 (85.115432739258): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (593.90068054199): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (104.90417480469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

109 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

110 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294756428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (521.89826965332): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294756428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1738.7866973877): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (!!!!! 1008.0337524414): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (943.89915466309): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

115 (157.11784362793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

116 (!!!!! 4173.9940643311): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

117 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

118 (806.09321594238): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

119 (77.962875366211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

120 (!!!!! 5399.9423980713): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

121 (!!!!! 5672.9316711426): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

122 (!!!!! 2539.8731231689): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 52285.90965271): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (!!!!! 1888.9904022217): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756428 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756428 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (679.01611328125): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (56.028366088867): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (263.92936706543): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (299.93057250977): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (602.96058654785): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (721.93145751953): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (242.94853210449): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (!!!!! 1133.918762207): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (59.127807617188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (138.99803161621): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (!!!!! 1419.0673828125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (710.01052856445): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (!!!!! 3321.8860626221): SELECT name FROM jos_deeppockets WHERE id=211

138 (401.02005004883): SELECT name FROM jos_deeppockets WHERE id=211

139 (!!!!! 1082.181930542): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (!!!!! 1122.9515075684): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (901.93748474121): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

142 (919.81887817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

143 (!!!!! 10055.065155029): TRUNCATE TABLE jos_trademed_module

144 (475.16822814941): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (439.16702270508): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294756428 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (379.08554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (643.01490783691): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 2496.0041046143): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

149 (895.02334594727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

150 (!!!!! 2835.9889984131): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (!!!!! 4260.0631713867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

152 (428.91502380371): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

153 (417.94776916504): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294756428 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294756428 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (426.05400085449): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (130.89179992676): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (30.994415283203): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (145.91217041016): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

158 (406.02684020996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294756428 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294756428 AND published='1' LIMIT 1

159 (56.028366088867): select jos_twitters.link from jos_twitters where cat=10

160 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

161 (27.894973754883): select jos_google_plus.link from jos_google_plus where cat=10

162 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

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