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 body of the actor and its expressive significance is an essential topic in studying acting . it is not only confined to the study of soul and body from philosophical aesthetic perspective , but also to study the conception and mechanism of such a dichotomy followed by theatre directors and theorists , who are highly concerned with the creativity of actors . The researchers believe that such a study would be of benefit for actors as well as others working in theatre .
The study falls into two sections . the first deals with the phi
... Show MoreLanguage plays a major role in all aspects of life. Communication is regarded as the most important of these aspects, as language is used on a daily basis by humanity either in written or spoken forms. Language is also regarded as the main factor of exchanging peoples’ cultures and traditions and in handing down these attributes from generation to generation. Thus, language is a fundamental element in identifying peoples’ ideologies and traditions in the past and the present. Despite these facts, the feminist linguists have objections to some of the language structures, demonstrating that language is gender biased to men. That is, language promotes patriarchal values. This pushed towards developing extensive studies to substantiate s
... Show MoreGiardiasis is an infection caused by the protozoan flagellate parasite Giardia spp. in the intestine. G duodenalis, a species complex of diverse genotypes that tend to demonstrate host specificity, is responsible for most veterinary health related infections; production animals, companion animals, and wildlife can all be infected. Abdominal pain and diarrhea, typically accompanied by steatorrhea, are the most common symptoms of Giardiasis. Cysts or antigens in feces are commonly used to diagnose the disease. Treatment regimens vary and are dependent on the indication. Control methods must include hygiene measures. Despite direct evidence of Giardia sp transmission to humans via polluted water supplies, our analysis will focus on some r
... Show MoreBackground: intravenous regional anaesthesia (IVRA) is an effective method of producing anaesthesia of the extremities. Disadvantages are the rapid loss of anaesthesia after the deflation of the tourniquet and the rapid development of postoperative pain. It is important to search for agents with longer durations of action, better nerve fibre selectivity, lesser degrees of motor blockade and lower incidences of systemic toxicity.Objectives: This study was designed to evaluate and compare the clinical effects of intravenous regional anaesthesia, with lidocaine alone, or in a combination with ketamine and atracurium for better analgesia, and to examine the possible clinical advantages of using muscle relaxants (i.e., atracurium) with intrav
... Show MoreThe current study aimed to identify the morphological description and branches of the bronchial tree and lung for the weasel
The aim of this paper is to introduce the concept of N and Nβ -closed sets in terms of neutrosophic topological spaces. Some of its properties are also discussed.
Mishrif Formation is the main reservoir in Amara Oil Field. It is divided into three units (MA, TZ1, and MB12). Geological model is important to build reservoir model that was built by Petrel -2009. FZI method was used to determine relationship between porosity and permeability for core data and permeability values for the uncored interval for Mishrif formation. A reservoir simulation model was adopted in this study using Eclipse 100. In this model, production history matching executed by production data for (AM1, AM4) wells since 2001 to 2015. Four different prediction cases have been suggested in the future performance of Mishrif reservoir for ten years extending from June 2015 to June 2025. The comparison has been mad
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