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.
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The researcher highlighted the general budget in Iraq for the period (2003-2018) facing the challenges of administrative and financial corruption, in addition to the fluctuations in oil prices, the repercussions and many problems suffered and will suffer the Iraqi government in the process of preparing the general budget of the state and weak contribution of the agricultural and industrial sectors and other economic sectors and neglect altogether, oil has become the main supplier in funding Iraq's budget after 2003, and the impact on the unemployment rates in Iraq, which recorded fluctuating rates and then increased during the period (2012-2018) to achieve this, an inductive method was adopted, using theoretical and descriptive a
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The research entitled "The political changes and economic developments in contemporary Turkish Backgrounds, manifestations and future possibilities" consists of the introduction, four sections and conclusions. The background details, its developments, and the transformation in the economic sector in Turkey were reviewed. The first section concentrated on the brief introduction about the political developments which happened since the independence of Turkey at 1923 with the highlight on the years after the receipt of the Freedom and Justice Party (Ak PARTi) the Turkish Government rule. The second section demonstrated the reality of Turkish economy before 2002, while the
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