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.
Having signed my eyes on the manuscript labeled (equity in the ancestral quarrel at the meeting of subordinate and representative metaphors) I was impressed by the process of achieving it; That manuscript came to light; to be seen by specialists in Arabic rhetoric and students of science, and supplement the library of rhetoric one of the sources ..
Simple, cheap, sensitive, and accurate kinetic- spectrophotometric method has been developed for the determination of naringenin in pure and supplements formulations. The method is based on the formation of Prussian blue. The product dye exhibits a maximum absorbance at 707 nm. The calibration graph of naringenin was linear over the range 0.3 to 10 µg ml-1 for the fixed time method (at 15 min) with a correlation coefficient (r) and percentage linearity (r2%) were of 0.9995 and 99.90 %, respectively, while the limit of detection LOD was 0.041 µg ml-1. The method was successfully applied for the determination of naringenin in supplements with satisfac
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Keys to four genera and twelve species of the subfamily Phlaeothripinae (Phlaeothripidae) were constructed, these are: Haplothrips; Karnyothrips; Phlaeothrips; and Dolicholepta ,and the species are: Haplothrips cerealis Priesner; Haplothrips tritici kurdjumov, Haplothrips hukkineni Priesner; Haplothrips subtilissimus (Haliday) ؛ Haplothrips reuteri Karny; Haplothrips jasonis Priesner; Haplothrips sallloumensis Priesner ; Haplothrips pharao Priesner ; Phlaeothrips sycomri Priesner ; Karnyothrips flavipus (Jones); Karnyothrips melaleucus (Bagnall) ; Dolicholepta micrurus (Bagnall). These were collected from Baghdad
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