Roberto Caldeyro-Barcia
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Roberto Caldeyro-Barcia (26 September 1921 – 2 November 1996) was a
Uruguay Uruguay (; ), officially the Oriental Republic of Uruguay ( es, República Oriental del Uruguay), is a country in South America. It shares borders with Argentina to its west and southwest and Brazil to its north and northeast; while bordering ...
an doctor who pioneered the field of
maternal–fetal medicine Maternal–fetal medicine (MFM), also known as perinatology, is a branch of medicine that focuses on managing health concerns of the mother and fetus prior to, during, and shortly after pregnancy. Maternal–fetal medicine specialists are physic ...
, or perinatology. His research with Dr. Hermógenes Alvarez created
Montevideo units Montevideo units are a method of measuring uterine performance during labor. They were created in 1949 by two physicians, Roberto Caldeyro-Barcia and Hermogenes Alvarez, from Montevideo, Uruguay. They are exactly equal to 1 mmHg within 10 minutes. ...
, a measure of
uterine The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the hollow organ, organ in the female reproductive system, reproductive system of most female mammals, including humans that accommodates the embryonic development, embryonic an ...
performance during
labor Labour or labor may refer to: * Childbirth, the delivery of a baby * Labour (human activity), or work ** Manual labour, physical work ** Wage labour, a socioeconomic relationship between a worker and an employer ** Organized labour and the labour ...
. He was a founding editor of the ''Journal of Perinatal Medicine'', a widely published author, a lecturer, and the only Uruguayan to be nominated for a
Nobel Prize The Nobel Prizes ( ; sv, Nobelpriset ; no, Nobelprisen ) are five separate prizes that, according to Alfred Nobel's will of 1895, are awarded to "those who, during the preceding year, have conferred the greatest benefit to humankind." Alfr ...
.


Early life

Caldeyro-Barcia's father, Joaquin, was a physician. His mother, Elvira, came from a family with a medical background. While attending the English School in
Montevideo Montevideo () is the Capital city, capital and List of cities in Uruguay, largest city of Uruguay. According to the 2011 census, the city proper has a population of 1,319,108 (about one-third of the country's total population) in an area of . M ...
, Caldeyro-Barcia was given the nickname "Bobby" by the headmistress, Ivy Thomas. His family and close friends called him "Bobby" throughout his life. Caldeyro-Barcia enjoyed sports; at the age of 15, he started to court his neighbor and horseback-riding partner, Ofelia Stajano. They became engaged in 1945, and were married in 1946. At age 17, Caldeyro-Barcia started studies under the Faculty of Medicine at the
University of the Republic The University of the Republic ( es, Universidad de la República, sometimes ''UdelaR'') is Uruguay's oldest public university. It is by far the country's largest university, as well as the second largest public university in South America and t ...
in Uruguay. He specialized in
obstetrical Obstetrics is the field of study concentrated on pregnancy, childbirth and the postpartum period. As a medical specialty, obstetrics is combined with gynecology under the discipline known as obstetrics and gynecology (OB/GYN), which is a surgic ...
physiology under the influence of outstanding researchers like
Corneille Heymans Corneille Jean François Heymans (28 March 1892 – 18 July 1968) was a Belgian physiologist. He studied at the Jesuit College of Saint Barbara and then at Ghent University, where he obtained a doctor's degree in 1920. Heymans won the Nobel Pr ...
(winner of the Nobel Prize for Physiology or Medicine, 1938) and
Bernardo Houssay Bernardo Alberto Houssay (April 10, 1887 – September 21, 1971) was an Argentine physiologist. Houssay was a co-recipient of the 1947 Nobel Prize for Physiology or Medicine for discovering the role played by pituitary hormones in regulating th ...
(co-winner of the Nobel Prize for Physiology or Medicine, 1947). He qualified in medicine nine years later.


Early career

Barcia graduated in December 1947. Upon graduating, he was appointed assistant professor of physiology in the Institute of Physiology in Montevideo. At the School of Medicine of Montevideo, he was instructor of physiology (1942–1947), assistant professor of physiology (1948), associate professor of physiology (1950), head of the Department of Obstetrical Physiology (1959), and professor and chairman of physiology (until 1965).


Montevideo units

In 1947, while still a medical student, Caldeyro-Barcia first collaborated with his Professor of Obstetrics, Hermógenes Alvarez. Together, they established a tracing system to monitor
intrauterine The uterus (from Latin ''uterus'', plural ''uteri'') or womb () is the organ in the reproductive system of most female mammals, including humans that accommodates the embryonic and fetal development of one or more embryos until birth. The uter ...
amniotic pressure during pregnancy and labor by measuring the intensity and frequency of contractions and the uterine tone, making it possible to analyze and define uterine contractility during pregnancy and childbirth. This research—which included the first recording of human uterus activity during labor— led to the duo's creation of Montevideo units to quantify uterine activity, now a worldwide standard in perinatal care. In 1950, he recorded for the first time intramiometrial pressure in different parts of the uterus during labor, defining the pattern of normal uterine contractility having a "triple descendant gradient".


Later career

In 1958, Caldeyro-Barcia and Alvarez developed a method to measure the effect of uterine contractions on
fetal heart rate A fetus or foetus (; plural fetuses, feti, foetuses, or foeti) is the unborn offspring that develops from an animal embryo. Following embryonic development the fetal stage of development takes place. In human prenatal development, fetal dev ...
, which would later become the basis of fetal monitoring, commonly used to monitor the fetus's response to contractions during labor and to prevent any neurological damage resulting from oxygen deprivation. They defined normal and abnormal responses of the fetus through the continuous monitoring of fetal heart rate. The pair referred to the typical abnormal response of the fetal heart rate during labor as "type II DIP"; the term was later changed to '' late deceleration'' by other researchers. Caldeyro-Barcia and his staff developed ''sub partu tocolysis'' in 1969. This ability to suppress premature labor may overcome around 70 percent of sub partu complications, avoiding unnecessary surgery. In 1970, the
Pan American Health Organization The Pan American Health Organization (PAHO) is an international public health agency working to improve the health and living standards of the people of the Americas. It is part of the United Nations system, serving as the Regional Office for ...
created the first Latin American Center of Perinatology (CLAP) in Montevideo, appointing Caldeyro-Barcia as its director. This became a training and reference center for professionals from Latin America and elsewhere. It provided training to doctors from Switzerland, the United States, Germany, Japan, Sweden, Spain, as well as a vast number of Latin Americans, many of whom are today faculty members in their countries of origin. Together with Edward Hon, Stanley James, and Erich Saling, Caldeyro-Barcia was a founding editor of the '' Journal of Perinatal Medicine''. The four founded the journal in 1973. Caldeyro-Barcia remained an editor of the journal until his death. From 1976 to 1979, Caldeyro-Barcia was the president of the
International Federation of Gynecology and Obstetrics The International Federation of Gynaecology and Obstetrics, usually just FIGO ("fee'go") as the acronym of its French name Fédération Internationale de Gynécologie et d'Obstétrique, is a worldwide non-governmental organisation representing ob ...
(FIGO). He was president of the organization's 1979 World Congress in
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. The World Association of Perinatal Medicine, the first world congress of this speciality, was founded in Tokyo in 1991 by a number of renowned scientists including Caldeyro-Barcia and Saling. Caldeyro-Barcia chaired the general assembly held immediately after the congress concluded, during which the international body's name was established. After Caldeyro-Barcia retired from the
chair A chair is a type of seat, typically designed for one person and consisting of one or more legs, a flat or slightly angled seat and a back-rest. They may be made of wood, metal, or synthetic materials, and may be padded or upholstered in vario ...
in Gynaecology at the University of the Republic, which was created for him, the government of Uruguay appointed him to direct a program that developed basic sciences at the university: Programa de Desarrollo de las Ciencias Básicas (PEDECIBA, "Program for the Development of Basic Sciences"). He held the post from 1984 until his death.


Awards

Caldeyro-Barcia received more than 300 awards, including: He was nominated three times for the
Nobel Prize The Nobel Prizes ( ; sv, Nobelpriset ; no, Nobelprisen ) are five separate prizes that, according to Alfred Nobel's will of 1895, are awarded to "those who, during the preceding year, have conferred the greatest benefit to humankind." Alfr ...
.


Honorary degrees

* PhD,
University of Santiago de Compostela , established = , type = Public , budget = €228 million (2011) , rector = Prof. Dr. Antonio López Díaz , city = Santiago de Compostela , state = Galicia , country = Spain , undergrad = 23,835 , postgrad = 1,716 , doctoral = 2,697 ...
, 1978


Legacy

The Global Congress of Maternal and Infant Health established the Roberto Caldeyro-Barcia Prize in Perinatal Medicine. Presented during the congress's opening ceremonies in
Barcelona Barcelona ( , , ) is a city on the coast of northeastern Spain. It is the capital and largest city of the autonomous community of Catalonia, as well as the second most populous municipality of Spain. With a population of 1.6 million within ci ...
, Spain in September 2010, the prize winner must be an expert in obstetrics and perinatal medicine. The winner receives an award of and a diploma.


References


Further reading

* * * * * * {{DEFAULTSORT:Caldeyro-Barcia, Roberto Uruguayan obstetricians 1921 births 1996 deaths Physicians from Montevideo University of the Republic (Uruguay) alumni Academic staff of the University of the Republic (Uruguay)