2. ie} Castlégar News November 30, 1988

i MEDICINE

Doctors encourage natural birth

WASHINGTON (AP) — Guide lines issued by the American College of Obstetricians and Gynecologists say women who have had babies delivered by caesarean section should be encourated to have later

children by normal, vaginal birth. Dr. Mary Jo O'Sullivan, a member of a panel set up by the college that developed the guidelines, said a pregnant women who has had an earlier child by caesarean section

Exercise better for the heart

NEW YORK (REUTER) Exer-. cise, and not just dieting, should play akey role in efforts to correct obesity and lower the risk of heart disease, the New England Journal of Medi. cine says.

The warning comes in an editorial commenting on the somewhat incon clusive results of a study, published in the weekly medical journal, on the benefits of exercise as opposed to dieting in the prevention of heart disease.

The year-long study, by doctors at Stanford University, concluded that “fat loss through dieting or exer cising produc omparable and favorable changes” in the concentra tions of life-threatening levels of fat in the blood stream.

It notes “evidence that reduction of body fat is more easily achieved when e: se is part of a weight-loss program” and that “a significant loss of non-fat body mass had been found in dieters but not in exercisers.”

But the study fell short of calling exercise more effective than dieting alone in the prevention of heart disease

Instead, it says both “should be more—strongly—emphasized—in—con. temporary campaigns to reduce risk of coronary heart disease such as the

National Cholesterol Education Pro- gram.”

The Journal editorial called the Stanford study “an important step toward understanding the role of physical activity and. diet in weight loss.

It added, however, that “the cor- rection of obesity in an affluent, sedentary society should not focus on decreased energy intake.

“shoulid be encouraged to attempt labor in her current pregnancy” instead of routinely undergoing a second surgical delivery.

Dr. O'Sullivan said if the new guidelines are accepted by U.S. hos pitals, they will goa long way toward ending a tradition that has guided obstetric practice since 1916.

The college committee found that women who have had a caesarean section procedure, a low transverse incision of the uterus, were success: ful in subsequent vaginal delivery attempts in most cases.

“Up to 70 per cent of these women

who had their first caesarean birth because of failure to progress in a long and difficult labor were able to deliver vaginally with their second child,” Dr, O'Sullivan said,

Since 1982, the college has urged physicians to encourage women to attempt vaginal deliveries even after prior caesarean sections.

LOW DEATH RATES

The action was taken after a number of studies indicated that mortality rates for-mother and child were lower among women who at tentpted labor than among those who chose repeated caesarean births.

Until recent years, it was believed that once a woman had had a caes arean: section, all subsequent chil- dren had to be delivered the same way. The number of caesarean sec- tions routinely performed in recent years, however, has declined and the new guidelines are intended to en- courage this trend.

In 1987, about 24.4 per cent of all live births in the United States, or 934,000 of 3.8 million, were per. formed by caesarean section. About 35, per cent of the surgical births were repeat caesarean sections.

The surgical procedure would

continue to be used where medically indicated, such as for some breech births, when there are signs that the baby is in distress, or following a difficult and prolonged attempt at labor.

The announcement by the college said caesarean sections will continue to be used for women who have had a previous “classical” caesarean. In this procedure, the uterus is incised vertically, a technique now rarely used. About 99 per cent of all caes- arean sections now use a transverse incision which goes from one side to the other, instead of up and down.

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“Rather it should hi: great er energy expenditure, with a dis: proportionately lower intake during the period of active weight loss.

“our interpretation of all these ob- servations,” the editorial says, re ferring to the Stanford study and

veral earlier clinical investigations, is that physical activity protects against coronary disease, at least in middle-aged men.

Though beneficial, the study stresses the need for moderation in exercise programs given the heigh tened risk of cardiac arrest, even in a healthy individual, during and short ly after strenuous physical activity.

Rather than running, for example, the editorial says “brisk walking is the reasonable prescription for sed. entary and middle-aged people who have not maintained their fitness from their youth.”

Virus and pill linked to cancer

TORONTO (CP) — Women infec: ted witha sexually transmitted virus in the cervix may increase their chances of getting cervical cancer by taking birth control pills, says a re searcher at Memorial University in St. John's, Nfld

Mary Pater, co-author of a study published in the current issue of the leading British science journal, Na ture, says she's not suggesting women with the papilloma virus should stop taking the pill

“However, we believe women should know about the possible risk factors,” Pater, a molecular virol ogist, said Tuesday in an interview from the Newfoundland university

More than 1,600 women in Canada will get cancer of the cervic this year and more than 425 women will die from cervical cancer, says the Nat ional Cancer Institute of Canada

Earlier studies have suggested the papilloma virus is linked to cancer of the cervic, the lower neck of the womb. The new study is the first to link the virus and the pill to cancer

“While we have known that the

virus ,is associated with cervical

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cancer, we also knew that infection with the virus along was not enough to cause cancer,” Pater said

In the study, cells like those lining the cervix were infected with. the virus and gompared with infected cells treated with a hormone related to the birth control hormone, Pater said

The cells infected with the virus alone did not become cancerous. The others did and caused tumors to de velop when injected into rats.

Vegetables may help

WASHINGTON (REUTER) — All those bran muffins people are munching to prevent colon cancer may not help in reducing the inci dence of the disease, cancer re searchers said. However, a study in the Journal of the U.S. National Cancer Institute says consumption of fruit and vegetables appears to have a protective effect

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