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.
Abstract
All of us are indispensable for this rule (the most important and important) individuals, whether we were groups of leaders or followers of peoples or countries because the rule provides adequate guarantees for the correct positions and drawing the plan for successful decision-makers matching with the balances of Sharia without incompatibility between religious or worldly interests or legal positions and therefore in the framework of the most important appointment And distinguish it from the important from the interests or the appointment of the most important and distinguish from the important from the evils and through this rule we learn about the scientific and practical solutions t
... Show MoreThroughout history, artists have played many important roles in society.
Generally speaking, the role of the artist is defined by the society he is part of.
Indeed, there are as many ideas as to the role of the artist and, ultimately the purpose
of art in society, as there are types of art. This is, as a matter of fact, neither a new
question- the dialogue has been present within art for centuries- nor probably one
that will ever fully be answered.
Tom Stoppard came to prominence in the mid-sixties, when art and politics
were closely linked, and theatre sought to change the world. Stoppard would have
none of that: his work has no overt message, no political program. In fact,
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(1960-2009). The results of the analysis revealed the existence of a causal relationship duplex (two-way) between the variables mentioned. which means the possibility of the use stock market indicators to pre
The systems cooling hybrid solar uses solar collector to convert solar energy into the source of heat for roasting Refrigerant outside of the compressor and this process helps in the transformation of Refrigerant from the gas to a liquid state in two-thirds the top of the condenser instead of two-thirds the bottom of the condenser as in Conventional cooling systems and this in turn reduces the energy necessary to lead the process of cooling. The system cooling hybrid use with a capacity of 1 ton and Refrigerant type R22 and the value of current drawn by the system limits (3.9-4.2A), the same value of electric current calculated by the system are Conventional within this atmosphere of Iraq, and after taking different readings
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