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
Uncertainty, the deeply-rooted fact that surrounding the investment environment, especially the stock market which just prices have taken a specific trend until they moved to another one for its up or down. This means that the volatility characteristic of financial market requires the rational investor an argument led towards the adoption of planned acts to gain greater benefit in the goal of wealth maximizing. There is no possibility to achieve this goal without the burden of uncertainty and the risk of systematic fluctuations of investment returns in the financial market after the facts of efficient diversification have pro
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Breast cancer is one of the most common cancers in females. In Iraq there are noticeable elevation in incidence rates and prevalence of advanced stages of breast cancer. Ferritin is intracellular iron storage protein abundant in circulation and its main application in differential diagnosis of anemia.
The level of serum ferritin was found raised in various cancers including breast cancer. The aim of this study was to assess whether the serum ferritin concentration would be altered in Iraqi women with breast cancer and it could be related to progression of disease.
Sixty eight females participated in this study. The mean age of these females was 53.25± 9.52 .The level of serum ferritin was measured in 24
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There is substantial data supporting the importance of both endogenous and exogenous estrogen in maintaining reproductive health and preventing chronic disease, androgens in women's health are rarely discussed. This is one of the first researches to investigate correlates of blood testosterone concentrations in women with osteopenia, in anticipation of the growing interest in the role of androgens in women's health. A 65 volunteer women were enrolled in the current study, they were divided into two groups, 35 postmenopausal women with osteopenia were in the first group, and the second group contained 30 postmenopausal women without osteopenia as a control. Blood samples were collected from all participants and analyzed for testosterone l
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The self-evident truth existing in today's business environment is the continuity of change and its continuity and turmoil, also its increase over time as it is more abundant, abundant, wide and complex than ever before, and it is the dominant feature in the business environment, as different organizations and operating units can find themselves shifting from the top to the bottom. And then it requires its departments to strive to adapt to these rapid and turbulent shifts and changes by bringing about a series of organizational and adaptive changes that are not limited to one organizational aspect only but rather include all organizational components. Accordingly, this research came to determine the readiness of public organizations to chan
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Banking reforms in many countries have focused on the efficiency enhance of the banking sector, including Iraq, in terms of indicative steps based on recommendations, policies and standards developed by international organizations, foremost of which are Basel III. In this paper, it has tried to highlight the reforms in Basel III and the impact of these reforms on the stability of the banking system in Iraq. As the research derives its importance from the idea that the sound banking system consists of a group of banks capable of employing their assets and obligations efficiently in financial intermediation and enjoying financial solvency. The stability of the banking system is an important factor in achieving the leading role of t
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Language Teaching & Leaning Problems at the Iraqi university level: Image & Reality
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