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.
It is no secret to anyone that studying and investigating books of jurisprudence, despite their suffering, is a pleasure that cannot be compared to pleasure, and it has benefits and importance that cannot be limited and summed up, and it has great fruits that researchers and students of knowledge reap, as well as enriching libraries with jurisprudential material, after dusting them and taking them out to the light of libraries to be seen. Researchers and scholars, generation after generation, so that this nation can benefit from this pioneering intellectual and scientific product that was written for us by our first ancestors of working scholars who enriched human civilization with this scientific material, which has become a beacon guid
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... Show MoreA new simple sensitive and selective spectrophotometric method has been
developed for the analysis of vanadium(V) in three randomly chosen samples from
river water at different locations by continuous flow injection analysis. The method
based on the oxidation of pyrogallol by vanadium(V) in acidic solution to form color
species and the same species was determined using homemade Ayah 6SX1-T-2D
solar cell analyser . Chemical and physical parameters were investigated using the
high intensity of snow white light emitted diode as a source. The linear dynamic
range for the instrument response versus vanadium(V) concentration was 1-200
mg.L-1 with correlation coefficient r = 0.9920. The limit of detection (S/N=3) was 70<
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