Background: Ultrasonography has been used to examine the thickness of the lower uterine segment in women with previous cesarean sections in an attempt to predict the risk of scar dehiscence during subsequent pregnancy. The predictive value of such measurement has not been adequately assessed. Objectives: To correlate lower uterine segment thickness measured by trans abdominal ultrasound in pregnant women with previous cesarean section with that measured during cesarean section by caliper and to find out minimum lower uterine segment thickness indicative of integrity of the scar.Methods: A prospective observational study at Elwyia Maternity Teaching Hospital, from January 2011 to January 2012. A total of 143 women were enrolled in the study. Those women who were included were pregnant with gestational age (36-40) weeks, all had history of previous one or more cesarean section. Transabdominal ultrasound measurement of thickness uterine segment thickness done with moderately full bladder before delivery and correlated with these measured directly during operation using a caliper. The sensitivity and specificity of ultrasound calculated with positive and negative predictive value. Results: The sensitivity and specificity of trans abdominal ultrasound in detecting patient at risk of scar dehiscence in patient with previous and cesarean section not starting uterine contractions were very high 90%and 92% respectively with positive and negative predictive value of 90% and 92% respectively with a cut off value of uterine segment thickness of 4.5 mm. It was also has high sensitivity and positive predictive value of 93.4% and 93% respectively with patients that started labor but with low specificity and negative predictive value of 50% and 38% respectively with the same cut off value.Conclusions: Sonographic lower uterine segment thickness is a strong predictor for uterine scar defect in women with prior Caesarean section. However, no ideal cut-off value can yet be recommended, whenever uterine contractions started. But this method carries a high sensitivity and specificity in patients who did not start uterine contractions with a cut-off value of 4.5 mm.
Hashimoto Thyroiditis (HT) is the most common autoimmune thyroid disease and the commonest cause ofhypothyroidism. C-reactive protein (CRP) is synthesized in hepatocyte in response to autoimmune disorders;strongly induced by IL-6. This study aimed to estimate serum IL-6 and CRP levels in autoimmune and non-autoimmune hypothyroidism. The present study included 60 Iraqi female hypothyroid patients divided to 30autoimmune and 30 non-autoimmune, with age ranged between 24-50 years and 30 healthy controls withage ranged between 27-52 years. Serum samples were collected from study groups. The levels of thyroidhormones (TSH, T4 and T3) were determined by using automated Chemiluminescence Immunoassay (CLIA)analysis system. Detection the levels of t
... Show MoreThe problem of this study lies in that NATO was formed in the first place to protect Europe from Warsaw Pact. The geographical and military strategy have been changed with the change of its mission and expanding its operation scope with the leadership of the USA in the international scens. The latter has made this organization as the military arm to tighten its control over strategic regions.
The research supposes that NATO state members confront security concerns and political and military issues that push to expand the organization. The importance of this study lies in knowing the new roles of NATO imposed by the United States. Therefore, the continuity and affi
... Show MoreErbil city is located in the northern Iraq with a population of over one million people. Due to water crises farmers usually use wastewater and well water for the agricultural production. In this study six stations were designed to sample waste water and three from well water to define waste water and ground water characteristics. In this study, Residual Na+ Carbonate, Mg++ hazard, salinity hazard, Kelley index, %sodium, total hardness, permeability index, potential salinity, sodium adsorption ratio, and Irrigation Water Quality Index (IWQI) were determined. The order of average cation concentrations in water was Mg2+> Ca2+ > Na+ > K+. While the proportion of main
... Show MoreA computational investigation is carried out in the field of charged –particle optics with the aid of numerical analysis method using the personal computer. The work is concerned with the design of electron gun with space-charge effect. The Finite element method (FEM) used in the solution of Poison's equation for determine the axial potential distribution of the two-electrode immersion lens operated under zero magnification condition , and from the solution of the paraxial ray equation the optical properties such as the focal length , spherical and chromatic aberration coefficients are determined, also a calculation of the brightness and perveance for the lens. The electrodes geometry was determined in two and three dimensi
... Show MoreComparative Analysis of Economic Policy Stability between Monarchical and Republican Systems: A Theoretical Fundamental Research
The objective of this work is to investigate the performance of a conventional three phase induction motor supplied by unbalanced voltages. An effort to study the motor steady state performance under this disturbance is introduced. Using per phase equivalent circuit analysis with the concept of symmetrical components approach, the steady state performance is theoretically calculated. Also, a model for the induction motor with the MATLAB/Simulink SPS tools has been implemented and steady state results were obtained. Both results are compared and show good correlation as well. The simulation model is introduced to support and enhance electrical engineers with a complete understanding for the steady state performance of a fully loaded induc
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