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Biomedical subjects

R M Rome

Publications and source records attributed to R M Rome.

26 records · Page 2Linked to original sources
PubMed1976

The use of the amniotic fluid lecithin/sphingomyelin (L/S) ratio, creatinine concentration and nile blue sulphate tests, individually and in combination, in the assessment of fetal lung maturity.

The lecithin-sphingomyelin (LS) ratio is a good, but not absolute, test of fetal lung maturity. A total of 373 infants was delivered within 72 hours of amniotic fluid collection for assessment of the L/S ratio. Five of 43 infants (11-6 per cent) with an L/S ratio of 2-2 or less developed the respiratory distress syndrome (RDS), whereas only one of 320 infants (0-31 per cent) with a higher L/S ratio developed RDS. The risk of RDS could be further defined by using the creatinine concentration (critical value 19 mg/1) and the Nile blue sulphate test (critical value 4 per cent) in combination with the L/S ratio. All three tests were performed in 320 pregnancies and in each instance delivery took place within 72 hours. When all three test results were low, 3 of 5 infants (60 per cent) developed RDS, whereas when all three results were high, none of 175 infants developed RDS. When one or two results were low, 2 of 140 infants (1-4 per cent) developed RDS.

Amniotic Fluid↗
PubMed1975

Secondary postpartum haemorrhage.

The clinical features of 106 women who had a secondary postpartum haemorrhage were examined in detail; 39 were managed conservatively, 3 had a vaginal laceration resutured and 64 had a curettage. In 46 patients, material obtained by curettage was examined histologically. The clinical features associated with retained products of conception are defined and comparisons are made between conservative and surgical management of secondary postpartum haemorrhage.

Curettage↗
PubMed1975

The benefits and risks of amniocentesis for the assessment of fetal lung maturity.

Amniocentesis for estimation of the lecithin: sphingomyelin (L/S) ratio was performed on 483 patients on 552 occasions. The introduction of this test has been associated with a highly significant (p less than 0-001) decrease of 59 per cent in the incidence of respiratory distress syndrome. The finding of a low L/S ratio (less than 2-0) enabled delivery to be deferred until lung maturity had been reached in 43 (10-3 per cent) of the 419 patients who had successful amniocentesis. Fetal death occurred after amniocentesis in two patients (0-41 per cent). One fetus died after haemorrhage occurred behind an anterior placenta and the other died of exsanguination. Failed amniocentesis occurred in 64 patients (13-2 per cent), and was more common when the placenta was anterior or was not located before the procedure and when fetal growth was retarded. Fetal distress in labour occurred more commonly after failed amniocentesis. Spontaneous labour followed amniocentesis in 47 patients (9-7 per cent) and was significantly more prone to occur after 38 weeks gestation. Rhesus isoimmunization did not occur in any of the rhesus-negative patients who delivered rhesus-positive babies and who were screened six or more months after amniocentesis, although anti-D immunoglobulin was not given routinely after amniocentesis. Suggestions are made as to how the success rate of this valuable procedure can be improved and how some of the serious fetal and maternal sequelae can be avoided.

Amniocentesis↗
PubMed1966

Twinning.

Explore the source record for details and available documents.

Female↗
PubMedDate not supplied

VIN 3: a clinicopathologic review.

A retrospective review of the management of vulvar intraepithelial neoplasia 3 (VIN 3) over a 16-year period from 1981 to 1997 was conducted. Complete information was available for analysis on 101 patients. The mean age was 53.9 years (range 14-102 years). The mean duration of follow-up was 36 months (range 2-184 months). Fifty-eight percent of patients presented with pruritus. The disease was multifocal in 51% and unifocal in 49% of cases and the left labium majus was the most frequently affected site (27%). Co-existent or previous genital disease was identified in 39% of patients and 8% had a history of invasive gynecological cancer. Histologic evidence of human papillomavirus (HPV) infection was found in 31% of patients. Wide local excision was the most frequently used treatment modality (78%). Thirty-eight percent of patients required at least one further treatment for recurrent disease. Smoking, multifocality, HPV effect, and positive surgical margins were not found to be significant predictors of recurrence. There were three (3%) cases of progression to invasive squamous cell carcinoma of the vulva, one at 6, 7, and 7 years after initial treatment.

Adolescent↗