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 treatment of migraine headache targets the neurovascular mechanism and involves the use of serotonin receptor antagonists. Some of these drugs are used for the treatment of acute attacks; while others are effective as prophylactic measures to decrease the duration and frequency of attacks. Pizotifen, a 5-HTA antagonist, is one of the prophylactic drugs for which the clinical use resulted in low outcomes in reducing migraine symptoms. Melatonin, a serotonin derived neurohormone, was reported to exert many functions like sleep induction, anti-inflammatory, neurovascular regulation, cytoprotection and modulation of neurotransmitter release. In the view of the involvement of serotonin in the pathophysiology of migraine a
... Show MoreBackground: Personality could be defined broadly as those characteristics of individuals that describe the pattern of feeling, cognition and behaving. Personality types can be measured by using one of personality type’s measures. Personality has been proposed to influence the oral health. The purpose of the present study was to assess the influence of Personality Types on caries experience in relation to salivary testosterone hormone among teachers in Baghdad city. Materials and Methods: Female teachers (n=534) of randomly selected schools were subjected to personality questionnaire using The Riso-Hudson Enneagram Type Indicator. Teachers were examined to estimate the caries experience according to the decayed-missing and filled i
... Show MoreThe Agricultural Policy is one of the most important tools adopted by the state to guide its economic and social activities through the delivery of suitable agricultural commodities to the consumer and in return to deliver agricultural inputs to the agricultural producers at the lowest possible cost to contribute in achieving a profit that helps the agricultural product to continue in the production process with the same efficiency and ambition. So as to help increase the contribution of the agricultural sector to GDP and achieve the best picture of sustainable agricultural development.
The research aimed at identifying the reality of agricultural policies and their role in achieving sustaina
... Show MoreIn Iraq, more than 1031 school projects have been halted due to disputes and claims resulting from financial, contractual, or other issues. This research aims to identify, prioritize, and allocate the most critical risk factors that threaten these projects’ success for the duration (2017-2022). Based on a multi-step methodology developed through systematic literature reviews, realistic case studies, and semi-structured interviews, 47 risk factors were identified. Based on 153 verified responses, the survey reveals that the top-ranked risk factors are corruption and bribery, delaying the payments of the financial dues to the contractors or sub-contractors, absence of risk management strategy, multiple change orders due
... Show MoreBackground: Neonatal septicemia is a major health problem in developing countries furthermore data on bacteriological profile in early onst sepses (EOS) and late neonatal sepsis (LOS) are lacking in context of continuous change in bacteriological profile and increasing resistant strains. Objectives: The study done to determine the pattern of organisms implicated in neonatal septicemia in a neonatal care unit and to measure the degree of bacterial resistance to some antibiotics.
Type of the study : cross –sectional study.
Methods: Confirmed cases of neonatal septicemia admitted at Al-Alwyia pediatric teaching hospital for the period from January 20
... Show More