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.
Flow unit and reservoir rock type identification in carbonates are difficult due to the intricacy of pore networks caused by facies changes and diagenetic processes. On the other hand, these classifications of rock type are necessary for understanding a reservoir and predicting its production performance in the face of any activity. The current study focuses on rock type and flow unit classification for the Mishrif reservoir in Iraq's southeast and the study is based on data from five wells that penetrate it. Integration of several methods was used to determine the flow unit based on well log interpretation and petrophysical properties. The flow units were identified using the Quality Index of Rock and the Indicator of Flow Zone. Th
... Show MoreJohn Dewey is an American philosopher and psychologist. He is one of the primary figures of the philosophy of pragmatism. He is considered one of its founders and one of the leaders of the philosophy of pragmatism. He is one of the most famous figures of the modern education on the international level. His name is associated with the philosophy of education, because he delved in defining the purpose of education and went on talking about linking the theories with the reality without being subject to the existing system and the inherited traditions no matter how ancient they were. He is the godfather of progressive or gradual education, and he is one of the pioneers who established the experimental school in America in cooperation
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The control function of important functions in the system of government for several reasons , perhaps the most important of the magnitude of spending and spending in one of the tools adopted in the implementation of the control function.
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