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.
PDBNRSIA Asst, International Journal of Research in Social Sciences and Humanities, 2018
Abstract
The study aims to find out the impact of expectations and perceptions in determining the position of the customer service quality received by him. Represent the expectations and perceptions customer’s key of service quality determinants. The customer's requirements and needs main pivot, who must be built all events and activities and efforts of service organizations, including the hotel and organizations that operate in an environment known as highly competitive , intensification and complexity of the conditions set by the customer and increasing day after day. The study sample of three Luxury hotels in Kurdistan region of Iraq a model. The use of service quality m
... Show MorePerceptions of deity have practical effects in a person’s life, especially in his attitudes toward natural things since nature was created, in which man has treated it as something sacred. The Greek philosophers before Plato and Aristotle did not find in them the idea of divinity clear. Rather, they all searched for the first substance or the first cause of existence, and then gave it all the attributes of God from eternity and eternity, and considered it a first reason without which the universe would not have existed. knowledg
Praise be to God, prayer, and peace be upon the Messenger of Allah and his God and his companions. The field of the judiciary to prove or invalidate some cases in the field of proof of descent and attachment to the plaintiff or exile, and other legal and judicial issues, especially in this era where the spread of previously unknown evidence, such as DNA, which was discovered in 1953, and the genetic fingerprint discovered 1984, blood analysis and a Saliva, sweat, poetry, etc. in the field of forensic evidence, in forensic medicine or medical expertise, it can be used to identify the killer, or verify his identity, using all the evidence in the scene, such as a point of blood or sweat, and the like So, as well as to prove the lineage is u
... Show MoreBackground: the condition of hallux valgus is considered as the most common deformities affecting females more than males, characteristically manifested as lateral deviation of the big toe and widening of first and second inter -metatarsal angle with a deformity of second toe in some severe cases. Objective: to make a radiological and clinical assessment of two surgical methods of osteotomy used in treatment of hallux valgu and to compare between them: first one is the distal dome osteotomy, and second one is a distal wedge metatarsal osteotomy. Patients and methods: a total of 36 feet of 28 patients suffer from hallux valgus, with mean age of 50.3 years were included in this study, followed for 6- 30 months ( mean follow-up of 8.8 months).
... Show MoreFilm and literature exchanges it’s influences since the early beginning of the motion pictures appearance .it was a phenomenon in other genres such as theatre ,short stories and novels .the film used out of this interaction with literature the content , themes and subjects whish were more attached to the society. based on that , the film gains it’s successes and wide spread of influences on it’s audiences who became more familiar with the motion picture style.Astrok , the French film critic wrote about “Camera the pain “ and called it as the a way of writing in the future .he was talking about the future’s role of the film .It is the importance of the film in the creation and documenting the life and its various fields.Becaus
... Show MoreBackground: The quality of drinking water is directly related to community health. Therefore, improving the quality of drinking reflects positively on the health situation in general. The studies that deal with the quality of drinking water in the city of Baghdad in terms of chemical or microbial content are very scanty. Objective: The current review highlights the most important studies and research articles that concern the quality of drinking water, both bottled water and tap water, in terms of chemical and biological contamination and chemophysical specifications for drinking water. Abstract: Studies have shown that drinking water in the city of Baghdad, especially tap water, contains certain levels of heavy metals,
... Show MoreIncreased the need to promote the profession of auditing, and improving the performance of the audit process, which comes through the effective implementation of its tasks, where the auditor collects the necessary data about the nature of client activity, and any other information it deems necessary to carry out the planning and development of the strategy for how to determine the procedures for implementing the audit process and the scope and timing for evidence clues in order to form an opinion technician neutral about the fairness of the financial statements, as required by the standards of the field work of the planning and supervision of the internal control and evidence to prove, but the failure of the auditor whether in th
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