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MATERNAL AND FETAL OUTCOMES IN EMERGENCY VERSUS ELECTIVE TWO OR MORE PREVIOUS CAESAREAN DELIVERIES
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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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Publication Date
Wed Apr 03 2013
Journal Name
Iraqi Journal Of Medical Sciences
Ligasure versus clamp and tie technique to achieve henostasis in thyroidectomy for benign diseases
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STUDY OF TINEA PEDIS IN DIABETIC VERSUS NON-DIABETIC PATIENTS
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Background : The aim of this work is to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients. Result : Tinea pedis was estimated to be the second most common skin disease in the United States, after acne. Up to 15% of the U.S., population may have tinea pedis. Across Europe and East Asia, prevalence rates reach 20 %. Methods: The Complete history taking regarding: age, sex, occupation, residency, history of diabetes and diabetic profile (fasting blood sugar and post prandial).and Clinical examination of the feet Aim of the study : The aim of this work was to study the clinical features and causative fungi of tinea pedis in diabetic and non-diabetic patients Conclusion : Tinea pedis is more

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