الفهرس 
Introduction and RationaleOnly 14 pages are availabe for public view
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Abstract
The appropriateness of the CS increasing rate all over the world has been debated broadly. Issues that relate to maternal choice, delivery mode for breech presentation at term, and VD subsequent to past scar have been highlighted; and much debate has concentrated on consequent morbidity of the mother and the neonate. Some studies favor elective CS owing to a childbirth fear, fearing of fecal and urinary incontinence subsequent to delivery, breech deliveries at term, and neonatal outcome as unexplained fetal death and complications of labor. Other surveys benefit VD as CS implied a greater possibility of maternal death, operative complications and a longer recovery time, a greater possibility of unexplained stillbirths in following pregnancies, and respiratory disorders of the neonate. Our results showed that ; Showing the most frequent indication of CS in women < 20 years old are chephalopelvic disproportion (CPD), malposition, malpresentation and failure to progress. While in women > 30 years old the most frequent indications are fetal distress, maternal request and postdate. Admission Hb is not significant between vaginal and cesarean mode of delivery as p=0.9591. On the other hands, Discharge Hb is highly significant higher in vaginal than cesarean mode of delivery as p=0.05 with significant higher incidence of aneamia in cesarean group (96.5% versus 7.5% in vaginal group. Which indicates strong relation between discharge Hb and incidence of aneamia but in negative direction i.e.: decreasing discharge Hb levels increases incidence of aneamia. There was a significant incidence of neonatal admission to NICU in CS group (75% of cases admitted due to respiratory morbidities and 1% due to fetal distress versus 1%&0% respectively in vaginal group) p=0.0019. Cesarean mode of delivery was significantly associated with higher incidence of fever (6%), post-cesarean cystitis (6%) and wound infections (2.5%) versus 1%, 0% &2% respectively in vaginal group. There was an association between ruptured membranes, cervical dilatation and rehospitalization with the postpartum infections. CS associated with significantly late onset of breast feeding, longer duration of postpartum bleeding, higher incidence of early dyspareunia and higher Incidence of rehospitalization than the vaginal delivery group. Women subjected to vaginal delivery had developed an early bowel habits, early ambulation, and early sexual resumption than the cesarean delivery There was a relationship between perineal injuries and episiotomy in negative direction i.e.: episiotomy decreases the incidence of perineal tears in vaginal delivery women. The neonate Apgar score at 1min & 5 min were > 7 representing 99% of the vaginally delivered women’s newborn. The fact that a cesarean section is a surgical procedure with numerous potential complications for both mother and child is evident in our study. On the hand Cesarean section delivery is considered the rescuer soldier at the time of need, saving many lives of mothers and their infants. This also was obvious in our study starting from choosing the cause of indicated Cesarean mode of delivery. The elective CS indicated in malposition, malpresentation, chephalopelvic disproportion, or maternal request showed gorgeous results on both maternal and fetal aspects. Even in cases of fetal distress, failure to progress or cord prolapse, CS put its magic touch and saved many lives, minimizing the drawbacks of proceeding vaginal delivery. These merits were documented as follow; the overall intrapartum anaesthetic complications were only 9 cases out of 200 case compared to191 case of no anesthetic problems. Surgical complications (organ damage, paralytic ilieus) encountered 6 cases out of 200 case leaving 194 case of no surgical complications.4 cases were in need for blood transfusion. Although the drawbacks observed post surgically of delayed breast feeding, bowel habits and early ambulation, the rescued infants needed no entry to NICU by percent of 91%. The female delivered by CS assured good health except 29 case (14%)who presented with post Cesarean cystitis, wound infection or fever . 12% only were rehospitalized including those who had blood transfusion. CS mode of delivery also had the benefit of preserved pelvic floor when compared to vaginal delivery .This merit can not be chosen as an indication of CS.