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.
In this investigation, Rayleigh–Ritz method is used to calculate the natural frequencies of rectangular isotropic and laminated symmetric and anti-symmetric cross and angle ply composite plate with general elastic supports along its edges. Each of the admissible functions here is composed of a trigonometric function and an arbitrary continuous function that is introduced to ensure the sufficient smoothness of the so-called residual displacement function at the edges. Perhaps more importantly, this study has developed a general approach for deriving a complete set of admissible functions that can be applied to various boundary conditions. Several numerical examples are studied to demonstrate the accuracy and convergence of the current s
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This research explored the performance of steel fiber concrete-filled stainless-steel tube columns stiffened with embedded carbon steel T-sections with various steel fiber ratios under biaxial bending conditions. A numerical parametric analysis was adopted, using finite element modeling with Abaqus CAE/2021 to evaluate the effects of the fiber ratio (ranging from 0% to 1.5%) on the load-bearing capacity and deflection behavior of columns. In addition, the compressive strength of concrete ranged between 45 and 65 MPa. An increase in the fiber ratio led to a substantial improvement in the ultimate load-bearing capacity (up to 24%), a reduction in deflection (of approximately 49%), and an improvement in column ductility, which were obt
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A numerical study of the two-dimensional steady free convection flow in an inclined annulus between two concentric square cavities filled with a porous medium is presented in this paper for the case when the side outer walls are kept with differentially heated temperature while the horizontal outer walls and the inner walls are insulated. The heated wall is assumed to have spatial sinusoidal temperature variation about a constant mean value. The Darcy model is used and the fluid is assumed to be a standard Boussinesq fluid. For the Cartesian coordinate system, the governing equations which were used in stream function form are discretized by using the finite difference method with successive under – relaxation method (SUR) and are solv
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Islamic law has relied on a number of sources in order to denote the rulings issued by them, including what is original and what is sub, and it is known to all scholars, that the Prophet's Sunnah is the second major source after the Koran, which separated the overall and devoted its year and restricted absolute. God Almighty obeyed the owner and his followers, and that his obedience of obedience to God Almighty said: (Who obeys the messenger has obeyed God) (women: 80), and then between the peasant who believes in him and his victory and follow him, he said: (and he said: And the one who was revealed with them were the successful ones (al-A'raf: 157).
It is known that the Sunnah commanded to follow is the