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 objective of the research is to determine the nature of the strategic direction of the institution and its impact on enhancing the indicators of institutional performance. The strategic direction is the main purpose for which it was found. Therefore, it is the main engine for all activities and tasks that the institution can carry out to achieve its objectives within the environment in which it operates. The promotion of corporate performance indicators is one of the major challenges that senior management must address in order to help the organization invest its human resources in the best possible way.
The research problem was determined by means of the intentional sample, consisting of (33) members
... Show MoreABSTRACT Background: Tuberculosis is a worldwide infectious disease in spite of advancement in health care system. Tuberculous lymphadenitis is the most prevalent form of extra pulmonary tuberculosis with predilection of cervical lymph nodes. Objectives: To evaluate the reliability of grey scale ultrasonography together with color Doppler in the diagnosis of cervical tuberculous lymph adenitis and evaluation of early therapeutic response. Subjects and methods:From July 2015 to May 2016 in Al-Karama teaching hospital /Kut city- Wasit-Iraq, 25 patients (14 males and 11 females) with ages range from (6-50) years. Ultrasonography examination was done for all patients and grey scale criteria (distribution, size, shape, echogenicity, echogenic hi
... Show MoreSteady conjugate natural convection heat transfers in a two-dimensional enclosure filled with fluid saturated porous medium is studied numerically. The two vertical boundaries of the enclosure are kept isothermally at same temperature, the horizontal upper wall is adiabatic, and the horizontal lower wall is partially heated. The Darcy extended Brinkman Forcheimer model is used as the momentum equation and Ansys Fluent software is utilized to solve the governing equations. Rayleigh number (1.38 ≤ Ra ≤ 2.32), Darcy number (3.9 * 10-8), the ratio of conjugate wall thickness to its height (0.025 ≤ W ≤ 0.1), heater length to the bottom wall ratio (1/4 ≤ ≤ 3/4) and inclination angle (0°, 30° and 60°) are the main consid
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... Show MoreFilled the place thought philosophers and ancient is the identity that you know The value of belonging to a World Geography existential - the spiritual , and Which is characterized by the structure humanity from one another and the Rest of the organisms they interact with him alone by environmental Conditions - surrounding has to achieve time through continuous movement Localized or comprehensive . The place is exemplified by making special Natural Great Creator, I believe making structure humanity combined - Individual interactive because of its influential role in all daily consumer Productions and creative arts, specifically drama's TV , because the place in Aesthetic discourse - TV drama directly affect the creating and building the
... Show MoreIn this numerical study a detailed evaluation of the heat transfer characteristics and flow structure in a laminar and turbulent flow through a rectangular channel containing built-in of different type vortex generator has been a accomplished in a range of Reynolds number between 500 and 100,000.A modified version of ESCEAT code has been used to solve Navier-Stokes and energy equations. The purpose of this paper is to present numerical comparisons in terms of temperature, Nusselt number and flow patterns on several configurations of longitudinal vortex generator including new five cases. The structures of heat and flow were studied, using iso-contours of velocity components, vortices, temperature and Nusselt n
... Show MoreThe study introduces the twentieth century background where the image of teacher is shaped by various factors according to the wide emergence of new educational institutions in the aftermath of the Second World War. A group of writers mirrored the influence of the war on educational institutions and accordingly on the image of teacher in their novels whose main action is set in and around the campus of a university. The genre dates back to the nineteen forties. where they show the foibles of human nature and reactions to external pressures. One of the early examples of this genre is Lucky Jim (1954). The image of teacher is swinged in many shapes from the tyrant to the rebellion to the defiant. All is personified in the characters of these
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