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G Heger-Römermann

Publications and source records attributed to G Heger-Römermann.

2 recordsLinked to original sources

[What factors modify the condition of the newborn infant in emergency cesarean section?].

Based on 207 emergency caesarean sections carries out in 66 maternity units in North Rhine Westphalia, the condition of the newborns (pH, UA and Apgar-index after 1 minute) was examined focusing the dependence of these variables from the time management (5 time factors were analysed). Rank-correlation coefficients according to SPEARMAN were calculated and a stepwise multiple regression analysis was performed. We found a significant (P less than 0.005) positive correlation on the one hand between the preparation time for the caesarean-section (time 1) and the actual pH (UA) and on the other hand between the total time (decision to perform a caesarean section up to the delivery of the baby (time 3)) and the actual pH, UA. No significant correlation was found between the time-factors and the Apgar-index (1 min). As the correlations are positive, this means that very low pH values are associated with short time intervals and high pH values with longer time intervals respectively. We concluded, that in case of an emergency caesarean section the urgency of the emergency itself controls and determines the time management. The spatial situation in each hospital which is reflected in the time factors 4 and 5 seems to be of less important for the overall result.

Acid-Base Equilibrium

[Emergency Cesarean section--basic data].

Performing a computerized multicenter-study of 66 clinics in the state of North-Rhine-Westfalia concerning the management of emergency caesarean-section (ECS), the resulting basic data were calculated as follows: In 207 cases of ECS studied, the time period needed from the decision for operation on to the beginning of surgery (DFOS) is on the average 20.4 +/- 12.3 minutes (Median 17 min., 90th Percentile 37 min.). The mere duration of surgery until delivery of the baby averaged to 4.4 +/- 2.1 min. (Median 4.0 min., 90th Percentile 7 min.). In an emergency case, on the average 24.8 +/- 12.9 minutes (Median 22 min., 90th Centile 43 min.) pass by from the decision for the operation until delivery. The median actual pH-value in umbilical artery blood of these neonates was 7.169 +/- 0.160 (N = 168). 25.0% of these neonates had pH-values below 7.1, 16.0% below 7.0 and 3.0% below 6.900. 20.1% of these babies had an Apgar-score of less than or equal to 3 after 1 min., 4 newborns received a score of 0, but recovered, whereas 4 other demised. The unpurified perinatal mortality amounted to 53.1/1000, the purified one to 48.3/1000. From these data we conclude for the time being, that 1. efforts have to be made to shorten the time factors (especially the first one (DFOS)), although there is still no evidence, that severe neonatal acidosis is significantly associated with undue long time factors in ECS; 2. further thorough analysis is need to evaluate the medical profile and the organizational background of these highest risk-deliveries.

Asphyxia Neonatorum