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 process of transformation from the central economy to a free economy requires restructuring the economy according to a new economic philosophy that relies on activating the role of private economic activity in which private and medium-sized institutions occupy an essential axis for their active role in the economies of all countries, especially those countries that have directed towards the market mechanism and sector leadership. The special process of economic development and the role that commercial banks can play in advancing the financing of these projects by establishing specialized business incubators for financing.
What encouraged countries to pay attention to these institutions is the ease of
... Show MoreHarriet Jacobs was a writer and a reformer. As a female writer in the nineteenth century, Jacobs wrote her narrative as a means of resisting the system of slavery. She wrote her book Incidents in the Life of a Slave Girl: Written by Herself, (1842) to reflect upon the exploitation of the black people and the need to change the hierarchal attitude that governs white/black relations. She was engaged in many abolitionist events and her anti-slavery approach appeared clearly in her writings. She shares Du Bios ideas about freedom and emancipation and the need for a political and cultural change. Thus, Du Bois’s theory provides a framework for her autobiographical novel where she portrays Linda Brent, the main character, a strong wille
... Show MoreCardiovascular disorders are refer to the class of diseases that involve the heart or blood vessels (arteries and veins). While the term technically refers to any disease that affects the cardiovascular system. Cholesterol is classified as a sterol (a contraction of steroid and
... Show MorePresent investigation aimed to study plasma BNP hormone estimation as predictor of brain stroke and neurocognitive in relative with other limitations in CKD patient. The case control experimental study was conducted on CKD patient at Yarmuk Hospital at Baghdad Province, Iraq from February to April 2020. The results showed that there were significant variances (P< 0.05) between CKD patients and control group, there was significant increase in BNP hormone and cystatin-C levels at patient, while ihematological parameters were significantly decreased. The parameters of lipid profile were significantly increased (P<0.05). The result revealed that there was relationship between BNP hormone level and CKD. This support that BNP level is related wit
... Show MoreThe Research is interested in the detailed comparative study of certain selection of
Imam Alsamarqandi in some subjects of washing and touching the Gracious Quran.
The value of this study is that it is related to one aspect of the duties obliged on Muslim
like parity.
The study has tried to collect certain scholars’ opinions of eight doctrines with the
selection of Alsamarqandi to make a comp arson between them and to show how
Alsamarqandi is able to create legal laws from his sources to lead the researchers nto have
knowledge about the syllabi of the famous scientists.
Finally we ask God to bless to what is right and to accept this study and make it part of
our good deeds, Ameen.
The research aims to develop a proposed mechanism for financial reporting on sustainable investment that takes the specificity of these investments.
To achieve this goal, the researcher used (what if scenario) where the future financial statements were prepared for the year 2026, after completion of the sustainable project and operation, as the project requires four years to be completed.
The researcher relied on the results of the researchers collected from various modern sources relevant to the research topic and published on the internet, and the financial data and information obtained to assess the reality of the company's activity and its environmental, social, and economic i
... Show MoreMunicipalities.
Abstract
The purpose of this research is to measure the impact of regulatory flexibility dimensions (formal and authoritarian procedures) to achieve response to the requirements of high performance dimensions (the effective recruitment, intensive training, motivate employees, participation of workers) in the general municipal Directorate as one of the directorates of the Ministry of Municipalities and Public Works. For the purpose of this measure it has been selected sample composed of 88 individuals from the research community represents the levels of assistant general manager of department heads and managers of people and some of the staff to answer the questionnaire prepared for the purpose Hama
... Show MoreThis research aims to measure the productivity of nursing services and recognize the reality of providing such services in some public hospitals in the province of Diyala, as well as identify the most important factors affecting the productivity of nursing services, and developer measure adopted by the researcher (Kien, 2012), which includes seven factors (workforce , management team, stimulation, pressure of working hours (time), material / equipment, supervision, safety), Used the experimental method in the search, one of the private scientific research curriculum depends primarily on the scientific experiment and study of the subject, or a scientific phenomenon, which provides an opportunity to learn the facts
... Show MoreThe purpose of this study is to investigate the histopathological response of dentinopulpal
response of human teeth to the Er: YAG laser cavity preparation in comparison with the conventional
class I cavity preparation. Thirty five sound human upper and lower first premolar teeth which were
needed to be extracted for orthodontic purposes were used in the study. Regarding to the method of
cavity preparation, the teeth were grouped into three groups; Group1; Control group which consists of
seven sound teeth without cavity preparation, Group2; Conventional cavity preparation group and group
3; Er: YAG laser cavity preparation group. Each of Group2 and3 consists of fourteen teeth that is
subdivided into: A. 7teeth that e