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.
AIM: To analyse our experiences in the management of traumatic retroperitoneal hematoma (RPH), highlighting the various challenges faced and to report on the outcome of these patients. METHODS: From May 2014 to May 2017, all patients with traumatic RPH who underwent surgical treatment were retrospectively analysed. The kind of injury, intraoperative findings, sites of hematoma, postoperative morbidity and the overall outcomes were recorded. RESULTS: Ninety-six patients; 53 with blunt trauma and 43 with penetrating injury, were included in this study. The centre-medial hematoma was observed in 24 (25%) patients, lateral hematoma in 46 (47.9%) patients, pelvic hematoma in 19 (19.8%) patients, and multiple zone hematomas in
... Show MoreBackground: Non-nutritive sucking habit (NNSH) is the main environmental causative factor that disturbs normal orofacial development. In spite of the harmful effect of pacifier as a NNSH, mothers aware from the other types of NNSH like thumb sucking far more than pacifier use. Open bite is one of the most challenging malocclusions in orthodontics due to the high prevalence of relapse after treatment, so preventing the causative factor of its occurrence is essential at early age of child life. This study aims to assess the impact of two non-nutritive patterns on the development of anterior open bite in primary dentition and to compare which of these habits mostly affect open bite development. Materials and Methods: The sample consisted of
... Show MoreBreast cancer is the most diagnosed form of malignant tumour in Iraqi women. Tamoxifen and trastuzumab are highly effective adjuvant therapy for breast cancer.
This study's objectives were to define the patient's belief in tamoxifen or trastuzumab when used as adjuvant therapy and to determine the variation in belief between the two medications in a sample of Iraqi breast cancer patients.
The cross-section survey was conducted using the BMQ-Specific questionnaire. Ninety-seven participants (sixty-seven tamoxifen, thirty trastuzumab) participated in this study.
The mean of specific-necessity scale for tamoxifen was (3.7) and for trastuzumab (4). The findings showed a high necessity for both medicines, and there wer
... Show MoreBreast cancer is the most diagnosed form of malignant tumour in Iraqi women. Tamoxifen and trastuzumab are highly effective adjuvant therapy for breast cancer. This study's objectives were to define the patient's belief in tamoxifen or trastuzumab when used as adjuvant therapy and to determine the variation in belief between the two medications in a sample of Iraqi breast cancer patients. The cross-section survey was conducted using the BMQ-Specific questionnaire. Ninety-seven participants (sixty-seven tamoxifen, thirty trastuzumab) participated in this study. The mean of specific-necessity scale for tamoxifen was (3.7) and for trastuzumab (4). The findings showed a high necessity for both medicines, and there were
... Show MoreCO2 Laser (10600nm) is the recent method in the management of challenging skin scar resulting from trauma, burn and surgical wound. The aim of this study was to evaluate the efficacy & safety of fractional CO2 laser (10600nm) in treatment of skin scar. Materials and Methods:Twenty patients with different types of scars treated with fractional CO2 (10600nm) laser, (10 patients) were given additional intralesional Triamcinolone. Results: All of the twenty patients included in this study showed some sort of improvements in scar texture, height and pliability and all of the ten patients who received intralesional Triamcinolone after laser show complete satisfaction. Conclusion:Fractional CO2 (10600nm) laser can be used as alternative, ef
... Show MoreBackground Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle.
Methods Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a mod
... Show MoreA vascular necrosis (AVN) is defined as cellular death of bone components due to interruption of the blood supply; the bone structures then collapse, resulting in bone destruction, pain, and loss of joint function. AVN is associated with numerous conditions and usually involves the epiphysis of long bones, such as the femoral head. In clinical practice, AVN is most commonly encountered in the hip. Early diagnosis and appropriate intervention can delay the need for joint replacement. However, most patients present late in the disease course. Without treatment, the process is almost always progressive, leading to joint destruction within 5 years. Treatment of a vascular necrosis depends mainly on early diagnosis which mainly based on clinical
... Show MoreBackground: Gray-scale sonography is generally
considered as a first-line diagnostic tool for patient with
suspected acute cholecystitis. It is suggested by gallstones,
Murphy's sign, thickening of the gallbladder wall and bile
sludging, but the specificity of these sonographic findings
are not as high as their sensitivity. Blood flow of the
gallbladder wall is increased in acute inflammation.
Objective: To evaluate the sensitivity and specificity of
power Doppler sonography and compared with conventional
color Doppler and gray-scale sonography in diagnosing
patients with acute cholecystitis.
Type of the study: This was a cross sectional study.
Patients and methods: The study was conducted t
KE Sharquie, AA Noaimi, BO Saleh, ZN Anbar…, Saudi Med J, 2009 - Cited by 13