Search PubMed⌕ Search

Biomedical subjects

V M Roemer

Publications and source records attributed to V M Roemer.

At least 19 recordsLinked to original sources
PubMed1991

[Comments on pH-metry in umbilical cord blood].

We report on a case of a premature newborn, delivered at 33rd week of gestation, weighting 1650 grammes, which had extremely low actual pH-values (UA: pH = 6,697; UV: pH = 6,803) but surprisingly good Apgar scores (8-10-10). During the following 6 weeks, the newborn did not present any neurological or other abnormalities. Against the background of this case report, all important variables of the fetal acid-base balance in the blood of the umbilical artery and vein are evaluated (Obstetrical data-base of the Department of Obstetrics and Gynaecology of the University of Tübingen, Prof. Dr. H.A. Hirsch). The study population included 2549 vaginal deliveries of singletons, born at term, without any malformations and without premature rupture of the membranes. In 1% of these newborn, the actual pH values in the blood of the umbilical artery were below 7.100 and 16% below 7.200. Computational analysis shows that in these foetuses, 86% of the foetal acidotic load, which must be eliminated by the mother, is due to foetal CO2 production, whereas only 14% is due to metabolic processes. Therefore, the distribution of actual foetal pH-values can be widely influenced by maternal breathing habits during the third stage of labour. We hypothesize that the wide range of pH-value distribution in different obstetrical departments might be due to a different management of the second stage of labour (duration and quality of bearing-down efforts, control of breathing, anaesthesia...). We conclude therefore, that even extremely low actual pH-values in umbilical blood do not necessarily relate to brain damage.

Acid-Base Equilibrium↗
PubMed1990

[Seroma formation and drainage technic following mastectomy].

Although seromas represent the most frequent postoperative complication of mastectomy, little attention has been paid in the literature to etiologic factors or therapy. In the present paper, a modified drainage technique is described which reduced the incidence of seroma formation after total mastectomy with removal of the axillary lymph nodes from 50% to 20.2%. Seroma formation was associated with drainage of significantly higher amounts of fluid. Seroma formation generally began on the 7th day after operation, reached a peak rate of growth on the 8th day, and subsequently slowed continuously up to the 16th day after operations. Age was revealed to be a very important etiologic factor: the frequency of seroma formation increasing with age.

Adult↗
PubMed1990

[The effect of intrauterine growth retardation and gestational age on status praesens of the newborn infant].

We investigated on the basis of 14,498 singleton births between the completed 24th and 42nd week of pregnancy, the dependence of the Apgar index after one minute and of the actual pH in the umbilical artery on two clinical variables 1. the duration of gestation and 2. the degree of intrauterine growth retardation. To determine the latter, each of the 14498 infant weights was transformed arithmetically to a percentile, i.e. a figure between 0 and 100. It was shown that the duration of pregnancy has a significant effect on increasing foetal acidity, which is greater (nonlinear correlation), the more immature the baby is. The influence of intrauterine growth retardation is slight but demonstrable in mature neonates and with adequate clinical management. In premature infants, especially in very small premature babies, intrauterine growth retardation becomes a major risk factor: increasing hypotrophy leads to a probably exponential rise of the acidity figures as well as to an increase in the percentage of low and very low Apgar scores. Hypertrophic premature babies and hypertrophic mature neonates are also subject to an increased risk. The effects mentioned above, of clinical maturity and intrauterine nutrient and oxygen supply on the unborn baby, result in a numerical continuity in the behaviour of the parameters: there are no abrupt alterations. This suggests, that the conventional definitions of hypotrophy or hypertrophy should be reconsidered. Furthermore, the data allow the conclusion, that prematurity and dysmaturity are two important variables thus suggesting an individual (i.e. non-schematic) obstetric procedure in premature deliveries.

Apgar Score↗
PubMed1979

[Treatment of diabetes during pregnancy with Des-Phe insulin: preliminary results (author's transl)].

Seven pregnant diabetics were treated with Des-Phe insulin (Hoe 01-S and Hoe 02-S). Daily blood glucose profiles were obtained for 7 to 32 weeks, a total of 4182 measurements. The blood glucose level was well controlled with the insulin preparation. Postprandial blood-glucose increase was counteracted so that even one hour after food the preprandial blood sugar concentration had been reached (Des-Phe insulin Hoe 01-S). This ensured normal carbohydrate metabolism during pregnancy. There were no side effects or skin allergies. The pregnancy proceeded uneventfully in all patients resulting in seven normal infants.

Adult↗
PubMed1979

Oscillation-frequency and baseline fetal heart rate in the last 30 minutes of labour.

The last 120 minutes of 394 intrapartum fetal heart rate (FHR) records of high technical quality were evaluated. Baseline FHR was estimated and oscillation frequency (OF) counted for each minute. There was a highly significant association between the baseline FHR and the number of oscillations/minute; an increase in baseline FHR of 10 beats/minute was associated with a fall of about one oscillation/minute. The highest mean OF (9.6 +/- 4.8 events/minute) was found in fetuses with an umbilical artery pH of between 7.20 and 7.25. The baseline FHR should be taken into account when assessing fetal condition.

Female↗
PubMed1979

The evaluation and significance of intrapartum FHR-oscillation patterns.

The last two hours of 342 intrapartum FHR records of high technical quality were evaluated visually with simple tools (compasses, caliper). All data were entered on punched cards (25 pro fetus) and analyzed using an IBM system 370/135. In 253 fetuses with an actual pH in the umbilical artery (UA) above 7.199 the oscillation frequency (OF) during the last 30 min. preceding delivery amounted to 9.5 +/- 4.5 (4615 minutes without decelerations or accelerations). The 5th percentile, the median and the 95th percentile were 2,9 and 18 per minute respectively. OF refers to the number of visually detectable turning points in baseline FHR. There exists a significant association (2 alpha less than 0.001) between the OF and the oscillation amplitude (OA) per minute: a reduction in OF is followed by a decrease in OA even in vigorous infants. In acidotic fetuses OF is decreased when compared with FHR minutes of equal OA in nonacidotic infants. However this becomes statistically significant only in fetuses with actual pH (UA) below 7.150 i.e. in fetuses with severe acidosis. These findings can explain why the loss of FHR variability as a single symptom may be misleading in individual cases.

Acidosis↗
PubMed1978

[Ambulatory blood sugar control of diabetics on insulin therapy during pregnancy by means of the Eyetone reflectometer].

The data obtained in this study show that sufficiently accurate blood glucose values can be obtained by the pregnant diabetic with the Eyetone reflectometer. It is possible to lower the blood glucose value of the pregnant diabetic to the normal range as soon as pregnancy is confirmed. Prolonged hospital confinement can be avoided by using this outpatient blood glucose measurement procedure.

Blood Glucose↗