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Thu Dec 9 03:57:02 EST 2010


Attempting a vaginal birth after cesarean (VBAC) is a safe and
appropriate choice for most women who have had a prior cesarean
delivery, including for some women who have had two previous cesareans,
according to guidelines released today by The American College of
Obstetricians and Gynecologists. The cesarean delivery rate in the US
increased dramatically over the past four decades, from 5% in 1970 to
over 31% in 2007. Before 1970, the standard practice was to perform a
repeat cesarean after a prior cesarean birth. During the 1970s, as women
achieved successful VBACs, it became viewed as a reasonable option for
some women. Over time, the VBAC rate increased from just over 5% in 1985
to 28% by 1996, but then began a steady decline. By 2006, the VBAC rate
fell to 8.5%, a decrease that reflects the restrictions that some
hospitals and insurers placed on trial of labor after cesarean (TOLAC)
as well as decisions by patients when presented with the risks and
benefits. In keeping with past recommendations, most women with one
previous cesarean delivery with a low-transverse incision are candidates
for and should be counseled about VBAC and offered a TOLAC. In addition,
"The College guidelines now clearly say that women with two previous
low-transverse cesarean incisions, women carrying twins, and women with
an unknown type of uterine scar are considered appropriate candidates
for a TOLAC," said Jeffrey L. Ecker, MD, from Massachusetts General
Hospital in Boston. To learn more go to
http://www.acog.org/from_home/publications/press_releases/nr07-21-10-1.cfm

 
 CPSC Proposes New Rules for Full-Size and Non-Full-Size Cribs The U.S.
Consumer Product Safety Commission (CPSC) voted (5 to 0) today to
approve proposed new mandatory standards to address the hazards posed by
full-size and non-full-size cribs. Serious safety hazards with cribs
have ranged from drop-side hardware or other drop-side entrapment issues
to failures of the mattress support and detachment or breakage of the
crib slats. All of these defects can create hazardous gaps allowing a
baby to become entrapped and suffocate or fall out of the crib. The
Consumer Product Safety Improvement Act of 2008 (CPSIA) directs CPSC to
issue mandatory safety standards for durable infant or toddler products.
CPSC’s notice of proposed rulemaking ("NPR") for cribs includes: a
standard for full-size cribs that is substantially the same as ASTM F
1169-10, Standard Consumer Safety Specification for Full-Size Baby
Cribs, with one modification . The one modification that CPSC is
proposing to the ASTM full-size crib standard would require cribs to be
tested without the re-tightening of screws between tests in order to
ensure that the tests reflect the lifetime use of the crib; and 
a standard for non-full-size cribs that is substantially the same as
ASTM F 406-10, Standard Consumer Safety Specification for Non-Full-Size
Baby Cribs/Play Yards, with certain modifications. These modifications
include adding certain requirements that apply to full-size cribs, such
as the mattress support performance requirement, the side-impact test,
and the order in which performance tests are to be done, applicable to
non-full-size cribs so that the new standard for non-full-size cribs is
more stringent. The proposal also would restore movable side latch tests
to the non-full-size crib standard and would clarify that the proposal
does not extend to play yards. To learn more go to
http://www.cpsc.gov/cpscpub/prerel/prhtml10/10301.html

 


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