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.
يشكل السياق جانبا مهماً في فهم الخطاب والمقصود هنا العرض المسرحي، من خلال ما يمده السياق للمتلقي من مؤشرات، يتم الاعتماد عليها في استكمال المعنى الظاهر بالمعنى المستتر، فالسياق يعتمد في الاصل على المحيط المادي الاجتماعي الذي يتم فيه التواصل وفيه يتعرف المرسل والمتلقي أحدهما على الآخر وتتبلور الصورة التي يحملها الطرفان أحدهما عن الآخر، الى جانب كونه يمثل الاحداث التي سبق لهما أن عاشاها والتبادل القولي
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In spite of Iraq's possession of vast oil wealth allows him to play an important role in the international energy market، he is still under the level. The production of oil doesn'<
... Show MoreThe Colour is one of important aspect of human activity, especially in General arts and press, and also is one of the essential elements to achieve and build the idea of design technology in the appropriate places, according to the space of designs work.
In a view of the colour and its relationship with the Semiotics, we can find that the objectives goals at the point of visual formats that’s «oral or written”. In last years, the intellectual concerns of Semiotics through eye contact methods, that’s meaning contact methods for get messages of sense of sight.
The semiotics term Can be defined into: (the sequential feature or network system has relations according agreed language rules, in a particular environment, also is a g