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.
Communities seek to achieve the economic growth through the optimal use of resources. The human resource is considered the most important of those resources where the insurance institutions take the larger role in the protection of this resource and reducing the impact caused by dangers realization that endures. The general Iraqi insurance company is considered the leading in the field of life insurance since it was founded, and until now.
This research is based on an analyzing the relation between premiums and compensations of life insurance, for individual and the group insurance, and a reality of the
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The aim of this study was to identify the effectiveness of using generative learning model in learning kinetic series on rings and horizontal bar in artistic gymnastics for men ,Also, the two groups were better in learning the two series of movements on the rings and horizontal bar . The experimental method was used to design two parallel groups with pretested and posttest .The sample included third graders at the College of Physical Education and Sports Sciences - University of Baghdad ,The third class (d) was chosen to represent the control group that applied the curriculum in the college, with (12) students per group. After conducting the tribal tests, the main experiment was carried out for (8) weeks at the rate of two units per week di
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