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 road network serves as a hub for opportunities in production and consumption, resource extraction, and social cohabitation. In turn, this promotes a higher standard of living and the expansion of cities. This research explores the road network's spatial connectedness and its effects on travel and urban form in the Al-Kadhimiya and Al-Adhamiya municipalities. Satellite images and paper maps have been employed to extract information on the existing road network, including their kinds, conditions, density, and lengths. The spatial structure of the road network was then generated using the ArcGIS software environment. The road pattern connectivity was evaluated using graph theory indices. The study demands the abstraction and examin
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The road network serves as a hub for opportunities in production and consumption, resource extraction, and social cohabitation. In turn, this promotes a higher standard of living and the expansion of cities. This research explores the road network's spatial connectedness and its effects on travel and urban form in the Al-Kadhimiya and Al-Adhamiya municipalities. Satellite images and paper maps have been employed to extract information on the existing road network, including their kinds, conditions, density, and lengths. The spatial structure of the road network was then generated using the ArcGIS software environment. The road pattern connectivity was evaluated using graph theory indices. The study demands the abstractio
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A robust and sensitive analytical method is presented for the extraction and determination of six pharmaceuticals in freshwater sediments.
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this study deals with effect of diabetes and hypertension on quality of life
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The seasonal variation of two groups of Zooplankton were studied in Diyala river and two branches , about 30Km from Diyala dam It was found that there are differences in the distribution of the two groups . Atotal of six species were identified of Copepoda in Diyala river and its two branches . The species are Cyclops vernalis . C . visinus , C . dimorphus , Mesocyclops laukartu ,Paracyclops affinis and Diaptomus reighardi , where recorded high annual density in Khalis stream . Its annual density was between 0.55 – 20.66 Ind . / L. Wheras, Cladocera group 14 species were identified . and the most disturbance spe
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