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.
Background: Calcaneus is a spongy cancellous bone with rich blood supply , its fracture heals more rapidly providing no occurrence of infection and soft tissue injury around ,no gross malposition of fragments. The associated pain leads to a major impairment in life quality. The aim of treatment for calcaneal fractures is the decrease of pain and rebuilding of walking ability for patients with normal foot shape and the ability to wear normal foot wear. To reduce complications, a minimally invasive technique for the treatment of displaced intra-articular fractures of the calcaneus was preferred to use. The purpose of this study was to determine whether the closed reduction and percutaneous K. wire fixation of displaced intra-art
... Show MoreBackground: Calcaneus is a spongy cancellous bone with rich blood supply , its fracture heals more rapidly providing no occurrence of infection and soft tissue injury around ,no gross malposition of fragments. The associated pain leads to a major impairment in life quality. The aim of treatment for calcaneal fractures is the decrease of pain and rebuilding of walking ability for patients with normal foot shape and the ability to wear normal foot wear. To reduce complications, a minimally invasive technique for the treatment of displaced intra-articular fractures of the calcaneus was preferred to use.
The purpose of this study was to determine whether the closed reduction and percutaneous K. wire fixation of displ
... Show MoreBackground: Avascular 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 base
... Show MoreA robust and sensitive analytical method is presented for the extraction and determination of six pharmaceuticals in freshwater sediments.
this study deals with effect of diabetes and hypertension on quality of life
The present study focused mainly on the buckling behavior of composite laminated plates subjected to mechanical loads. Mechanical loads are analyzed by experimental analysis, analytical analysis (for laminates without cutouts) and numerical analysis by finite element method (for laminates with and without cutouts) for different type of loads which could be uniform or non-uniform, uniaxial or biaxial. In addition to many design parameters of the laminates such as aspect ratio, thickness ratio, and lamination angle or the parameters of the cutout such as shape, size, position, direction, and radii rounding) which are changed to studytheir effects on the buckling characteristics with various boundary conditions. Levy method of classical lam
... Show MoreBinary mixtures of three heavy oil-stocks had been subjected to density measurments. The data had been aquired on the volumetric behaviour of these systems. The heavy oil-stocks used were of good varity, namely 40 stock , 60 stock, and 150 stock, 40 stock is the lightest one with the API gravity 33.7 while 60 stock is middle type and 150 stock is heavy one, with API gravity 27.7 and 23.8 respectively. Stocks with Kerosene or Xylene for non-ideal mixtures for which excess volume can be positive or negative. Mixture of heavy-oil stocks with paraffinic spike (Kerosene) show negative excess volume. While, aromatic rings results a lower positive excess volume, as shown in Xylene when blending with 40 stock and 60 stock but a negati
... Show MoreAs a result of the significance of image compression in reducing the volume of data, the requirement for this compression permanently necessary; therefore, will be transferred more quickly using the communication channels and kept in less space in memory. In this study, an efficient compression system is suggested; it depends on using transform coding (Discrete Cosine Transform or bi-orthogonal (tap-9/7) wavelet transform) and LZW compression technique. The suggested scheme was applied to color and gray models then the transform coding is applied to decompose each color and gray sub-band individually. The quantization process is performed followed by LZW coding to compress the images. The suggested system was applied on a set of seven stand
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