Background: Ultrasonography has been used to examine the thickness of the lower uterine segment in women with previous cesarean sections in an attempt to predict the risk of scar dehiscence during subsequent pregnancy. The predictive value of such measurement has not been adequately assessed. Objectives: To correlate lower uterine segment thickness measured by trans abdominal ultrasound in pregnant women with previous cesarean section with that measured during cesarean section by caliper and to find out minimum lower uterine segment thickness indicative of integrity of the scar.Methods: A prospective observational study at Elwyia Maternity Teaching Hospital, from January 2011 to January 2012. A total of 143 women were enrolled in the study. Those women who were included were pregnant with gestational age (36-40) weeks, all had history of previous one or more cesarean section. Transabdominal ultrasound measurement of thickness uterine segment thickness done with moderately full bladder before delivery and correlated with these measured directly during operation using a caliper. The sensitivity and specificity of ultrasound calculated with positive and negative predictive value. Results: The sensitivity and specificity of trans abdominal ultrasound in detecting patient at risk of scar dehiscence in patient with previous and cesarean section not starting uterine contractions were very high 90%and 92% respectively with positive and negative predictive value of 90% and 92% respectively with a cut off value of uterine segment thickness of 4.5 mm. It was also has high sensitivity and positive predictive value of 93.4% and 93% respectively with patients that started labor but with low specificity and negative predictive value of 50% and 38% respectively with the same cut off value.Conclusions: Sonographic lower uterine segment thickness is a strong predictor for uterine scar defect in women with prior Caesarean section. However, no ideal cut-off value can yet be recommended, whenever uterine contractions started. But this method carries a high sensitivity and specificity in patients who did not start uterine contractions with a cut-off value of 4.5 mm.
Abstract
This study aims to identify the most prominent factors that lead to bullying of students with intellectual disabilities in primary and middle schools from the perspectives of special education teachers. A quantitative descriptive approach was utilized. A questionnaire was used as a tool for data collection. The sample consisted of (72) male and female teachers from the Asir region in the Kingdom of Saudi Arabia. The results revealed the most prominent factors that lead to bullying as follows: factors associated with the school and its policies, factors associated with peers, factors associated with students with intellectual disabilities, and factors associated with general education teachers. The findin
... Show MoreControlling public expenditures is one of the main objectives of the public budget. The public budget often suffers from a deficit, whether in developed or developing countries, because expenditures are usually greater than the revenues generated. This requires the existence of financial rules that are adhered to by the government, which in turn leads to discipline. Fiscal policy leads to a reduction in the obligations incumbent on the government. Adhering to the financial rules would correct the course of fiscal policy in Iraq, with the need to direct oil revenues in the years of financial abundance when global oil prices rise to sovereign funds similar to other rentier countries, which contributes to maintaining the stabi
... Show MoreDue to the vast using of digital images and the fast evolution in computer science and especially the using of images in the social network.This lead to focus on securing these images and protect it against attackers, many techniques are proposed to achieve this goal. In this paper we proposed a new chaotic method to enhance AES (Advanced Encryption Standards) by eliminating Mix-Columns transformation to reduce time consuming and using palmprint biometric and Lorenz chaotic system to enhance authentication and security of the image, by using chaotic system that adds more sensitivity to the encryption system and authentication for the system.
The volatility of the financial markets and the oil market plays a major role in influencing macroeconomic activity, as well as the high interaction between the both markets and the remarkable sensitivity to their each other fluctuations which cause the undesirable impact on other economic sectors as an expected result due the mentioned interaction.
The study aimed to analyze the relationship between the volatility of the major US market indices represented by the DJIA index, S & P500, due to their comprehensiveness of the financial market, as they summarize the performance of the entire US market which is the largest economy in the world, as well as the difference in the calculation mechanism, and oi
... Show MoreObjective: To determine the effect of instructional program on infertile women's knowledge regarding
diagnostic and therapeutic intervention for infertility.
Methodology: Non-probability (purposive sample) of (100) infertile women, who visit Kamal Al-Samaraee Hospital/
fertility and IVF center. The data are collected through the use of constructed questionnaire, which included:
demographic characteristics, social status, previous medical history, reproductive status, sexual status and questions
regarding women’s knowledge about infertility. Instrument validity and reliability was determined. Data were
collected through the use of questionnaire, the application of the instructional program was done for the study group<
The study aims to identify the effects of dubbed Turkish drama on the public through the application of a sample of the views of women. The study also attempts to monitor the causes and motives due to the act of observation and to identify the various effects of this act. In order to achieve these goals, the researcher relies on the descriptive approach in addition to the questionnaire and interviews to collect data. It ends with a number of results such as: The study aims to identify the effects of dubbed Turkish drama on the public through the application of a sample of the views of women. The study also attempts to monitor the causes and motives due to the act of observation and to identify the various effects of this act. In ord
... Show MoreThe search aims to clarify pollution to negative effects on environment and to an increasing in the dangerous polluted materials that discharged out these factories. To make active procedures in order to limit the environmental pollution.
The search problem came from an assumption which has the researched factory is suffering from the lack of applying the international specification ( ISO 14004 ). The research problem assimilated by these questions:
- What is the level or organization in thinking of environmental system according to ISO 14004 .
- What are the requirements used in researched factor