BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7059.762 (Published 21 September 1996) Cite this as: BMJ 1996;313:762

One third of all elective caesarean sections follow previous sections, but obstetricians in the United States are trying to persuade women to have a trial of labour rather than opt for a second section (New England Journal of Medicine 1996;335:689-95). A prospective study of 3249 women who chose a trial of labour and 2889 who chose a caesarean section found few major complications, but these were twice as common in the women having trials of labour as in those having sections. Two perinatal deaths were associated with rupture of the uterus.

The human papillomavirus most often associated with carcinoma of the cervix, human papillomavirus 16, was thought until recently to be transmitted almost exclusively by sexual contact. A review in the “British Journal of Obstetrics and Gynaecology” (1996;103:853-8) presents evidence that the virus may be acquired by an infant during its passage through the birth canal. As many as half of all pregnant women may have asymptomatic infection with human papillomavirus 16, and there is no consensus on what should be done, if anything, to prevent its transmission to the next generation.

Recent improvements in implantable blood pumps used as bridges to heart transplant operations have revived interest in the development of permanent mechanical cardiac supports (Heart 1996;76:200-6). The Jarvik …

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