Background: Women with previous two or
more caesarean deliveries are usually
managed by elective cesarean section to avoid
the possible risks of labor.
Objective: To compare the relative risks of
maternal and fetal outcomes in emergency
versus elective previous two or more
caesarean deliveries
Design: Randomized prospective clinical
study
Setting: Al-Elweya Maternity Teaching
Hospital, from 1st of March to 31st of
September 2008.
Methods: The study groups, those who had
previous two or more caesarean deliveries,
were included from the hospital admissions.
The 1st group (102 women) presented in labor
and was managed by caesarean delivery as
soon as it was possible. The second group (78
women) was admitted for elective cesarean
delivery.
The main maternal outcomes were intra
operative complications, including
hysterectomy, scar dehiscence, bladder
injuries, uterine and internal iliac arteries
ligation, and blood transfusion. Postoperative
maternal outcomes were severe morbidity
including bleeding, fever, urinary tract
infection, blood transfusion, the need to
Intensive Care Unit admission and
readmission. The fetal outcomes measures
were Apgar score at one and five minutes,
respiratory distress syndrome (RDS),
admission to the neonatal intensive care unit
and fetal loss up to hospital discharge.
Results: Both groups were comparable in
demographic, social and past obstetric history
characteristics. Intra operative complications
showed significant difference in bowel
adhesions (RR 0.35, 95% CI 0.14- 0.88), and
blood transfusion (RR 0.51, 95% CI 0.28-
0.94). There was statistical significant
difference in the mobilization time 7.2 hours
and 9.3 hours in emergency and elective
groups respectively (p= 0.0009), also in
feeding time, it was shorter after emergency
caesarean section (P=0.0224), and in the
hospital stay 24.6 and 32.6 hours respectively
(p=0.0001). There was no statistical difference
in post operative complications. Fetal
outcomes showed no statistical significant
difference in fetal loss, respiratory distress and
readmission.
Conclusion: Women with previous two or
more caesarean deliveries can wait until
starting labor for doing cesarean delivery
without increasing risks to the mother and
fetus.
The impact of the auditor's personal judgment starts from the beginning of the audit process to the formation of the final opinion and the issuance of the report, and because of the possibility of bias in the auditor's judgment for various reasons that may relate to the auditor himself or the circumstances surrounding it, which requires assessing the current reality of the auditor's personal judgments In the local environment and determining their determinations. To clarify the concept and determinants of the auditor's personal judgments when implementing the audit work, prepare the report and determine the role of the international auditing standards in rationalizing the auditor's personal judgment when conducti
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This study aims to identify the social and psychological abuse towards elderly people by others, to identify the difference of social and psychological abuse towards elderly by others according to the variable of gender (male and female). Additionally, to identify the difference of social and psychological abuse towards elderly by determining the one who is responsible of abusing (son, daughter, spouse, etc.). To achieve this aim, the researcher designed a scale to identify the social and psychological abuse towards elderly by others. The results showed that this sample exposed to psychological abuse by different sides due to lacking of powers. Besides, the result showed that there are no signifi
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