This blog is a follow-up to our March 3 blog where we announced the NIH Consensus Development conference scheduled on March 8-10 to discuss the safety issues surrounding vaginal birth after previous Cesarian section. AHRQ has released a report from that meeting that found that vaginal birth after cesarean section is a safe and reasonable choice for a majority of women. Each year, more than 1 million cesarean surgeries are performed, and in 2007 nearly one in three births was cesarean in the U.S. A steady increase in repeat cesarean births over the past decade has been attributed, in part, to studies that suggested there may be significant harms associated with vaginal birth after cesarean section. Investigators found evidence which showed that while rare, maternal mortality was significantly higher for elective repeat cesarean versus trial of labor. Additionally, risks for uterine rupture and perinatal death remain rare, but elevated for trial of labor. Other important outco
The FDA recently issued the following communication report: Patients and healthcare professionals may have questions about oral bisphosphonate medications and atypical subtrochanteric femur fractures – fractures in the bone just below the hip joint. Oral bisphosphonates are commonly prescribed to prevent or treat osteoporosis in postmenopausal women. Common brand names of medications in this class include Fosamax, Actonel, Boniva, and Reclast. Recent news reports have raised the question about whether there is an increased risk of this type of fracture in patients with osteoporosis using these medications. At this point, the data that FDA has reviewed have not shown a clear connection between bisphosphonate use and a risk of atypical subtrochanteric femur fractures.
Vaginal birth after cesarean (VBAC) is the delivery of a baby through the vagina after a previous cesarean delivery. For most of the 20th century, clinicians believed that once a woman had undergone a cesarean, all of her future pregnancies required delivery by that procedure as well. In the 1980s, vaginal birth after cesarean (VBAC) also began to be considered a viable option for these women. Since 1996, however, VBAC rates in the United States have consistently declined, while cesarean delivery rates have been steadily rising. What accounts for these changing practice patterns?