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MATERNAL AND FETAL OUTCOMES IN EMERGENCY VERSUS ELECTIVE TWO OR MORE PREVIOUS CAESAREAN DELIVERIES
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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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Publication Date
Sat Sep 28 2024
Journal Name
Journal Of The Pakistan Medical Association
Pulse transmission time and amplitude of digital pulse wave determined by fingertip plethysmography as a surrogate marker of brachial artery flowmediated dilatation
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Objectives: To assess the changes in blood vessel stiffness and digital pulse wave amplitude because of flowmediateddilatation, and to explore how these two variables change when endothelial dysfunction isexperimentally induced.Method: The experimental study was conducted at the departments of physiology at the College of Medicine,Mustansiriyah University, and the College of Medicine, Al-Iraqia University, Baghdad, Iraq, from October 14, 2021, toMay 31, 2022, and comprised healthy young males who were subjected to the flow-mediated dilatation techniqueon the left brachial artery. Pulse transit time and the amplitude of the digital pulse wave were measured duringreactive hyperaemia for 2.5 minutes from the left middle finger using a

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Thu Jun 30 2022
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Sat Feb 14 2026
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Evaluation of shear bond strength of artificial teeth to heat cure acrylic and high impact heat cure acrylic using autoclave processing method
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