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 this research paper is two-fold. The first is a precise reading of the theoretical underpinnings of each of the strategic approaches: "Market approach" for (M. Porter), and the alternative resource-based approach (R B V), advocates for the idea that the two approaches are complementary. Secondly, we will discuss the possibility of combining the two competitive strategies: cost leadership and differentiation. Finally, we propose a consensual approach that we call "dual domination".
Fetal growth restriction is a significant contributor to fetal morbidity and mortality. In addition, there are heightened maternal risks associated with surgical operations and their accompanying dangers. Monitoring fetal development is a crucial objective of prenatal care and effective methods for early diagnosis of Fetal growth restriction, allowing prompt management and timely intervention to improve the outcomes. Screening for Fetal growth restriction can be achieved via many modalities; it can be medical, biochemical, or radiological. Some recommended combining more than one for better outcomes. Currently, there is inconsistency about the best method of Fetal growth restriction screening. In this review, a comprehensive
... Show MoreDiabetes mellitus, with adverse neonatal events are challenging issues to all obstetricians and pediatricians, where uric acid could play a vital role. We aimed to assess the relationship and prognostic benefits of serum uric acid measured at about 20 weeks’ gestation in normotensive pregnancy, with subsequent maternal diabetes, and neonatal complications. All singleton normotensive pregnant women with normal blood glucose, serum creatinine, and weight before pregnancy, whom attended Medical City Hospital, Department of Obstetrics and Gynecology in Baghdad, were involved and regarded as the case group, on the condition that their serum uric acid measured at 20 weeks’ gestation > 3 mg/dl, but if ≤ 3 mg/dl, they would be regi
... Show MoreEmergency vehicle (EV) services save lives around the world. The necessary fast response of EVs requires minimising travel time. Preempting traffic signals can enable EVs to reach the desired location quickly. Most of the current research tries to decrease EV delays but neglects the resulting negative impacts of the preemption on other vehicles in the side roads. This paper proposes a dynamic preemption algorithm to control the traffic signal by adjusting some cycles to balance between the two critical goals: minimal delay for EVs with no stop, and a small additional delay to the vehicles on the side roads. This method is applicable to preempt traffic lights for EVs through an Intelli
Binary mixtures of three, heavy oil-stocks was subjected to density measurements at temperatures of 30, 35 and 40 °C. and precise data was acquired on the volumetric behavior of these systems. The results are reported in terms of equations for excess specific volumes of mixtures. The heavy oil-stocks used were of good varity, namely 40 stock, 60 stock, and 150 stock. The lightest one is 40 stock with °API gravity 33.69 while 60 stock is a middle type and 150 stock is a heavy one, with °API gravity 27.74 and 23.79 respectively. Temperatures in the range of 30-40 °C have a minor effect on excess volume of heavy oil-stock binary mixture thus, insignificant expansion or shrinkage is observed by increasing the temperature this effect beco
... Show MoreThe knowledge of transferring body organs or tissues appears in the ancient mythology of Roman, Greek, Indian, Chinese, and Egyptian civilizations. The stories of organ transplants performed by GODs and health care’s using organs from cadaveric and after that transplantation change from lore to medical training
Recently, the increasing demand to transfer data through the Internet has pushed the Internet infrastructure to the nal edge of the ability of these networks. This high demand causes a deciency of rapid response to emergencies and disasters to control or reduce the devastating effects of these disasters. As one of the main cornerstones to address the data trafc forwarding issue, the Internet networks need to impose the highest priority on the special networks: Security, Health, and Emergency (SHE) data trafc. These networks work in closed and private domains to serve a group of users for specic tasks. Our novel proposed network ow priority management based on ML and SDN fullls high control to give the required ow priority to SHE dat
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