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.
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... Show MoreBinary 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
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The questionnair’e has been used as a basic instrument to gather data , As well as personal interviews with some of the staff of the research sample of private banks which were represented by (5) and included banks (Bank of Assyria for investment, the North Bank for Finance and Investment , Bank of the Tigris
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