Hemodynamic Adaptations at Birth and Neonates Delivered Vaginally and by Cesarean Section

Agata, Youtaro; Hiraishi, Satoshi; Misawa, Hitoshi; Han, Jae Hee; Oguchi, Kouki; Horiguchi, Y; Fujino, Nobuyuki; Takeda, Nobuhiro; Padbury, Jamés F.

doi:10.1159/000244263

Cited by 32 publications

(19 citation statements)

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“…These changes are likely a part of neonatal adaptation after birth. 3,6,[23][24][25][26] As shown in earlier studies, the intracranial and visceral hemodynamics change dramatically after birth, and a severe increase in the BFV and decrease in cerebrovascular resistance take place during the first 5 days of life, with the largest changes occurring within the first 24 hours. 3,5,25 Previous studies have found a significant increase of the cerebral BFV by as early as 12 hours of age.…”

Section: Discussionmentioning

confidence: 55%

Developmental Changes in Cerebral and Visceral Blood Flow Velocity in Healthy Neonates and Infants

Ilves

Lintrop

Talvik

et al. 2008

Journal of Ultrasound in Medicine

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Objective. The purpose of this study was to evaluate the changes in Doppler blood flow velocity (BFV) in cerebral and visceral arteries during infancy. Methods. The BFV was measured in 37 healthy term neonates in the anterior cerebral artery (ACA), middle cerebral artery (MCA), basilar artery, internal carotid artery (ICA), celiac artery (CA), superior mesenteric artery (SMA), and renal artery (RA). Results. The mean BFV increased and the resistive index decreased (P < .05) in all cerebral arteries, SMA, and CA by the age of 12 to 23.9 hours and in the RA by the age of 24 to 35.9 hours compared with 2 to 11.9 hours. A further significant increase (P < .05) of the mean BFV occurred in all arteries except the ICA and CA by the age of 72 to 120 hours compared with 12 to 23.9 hours. By the age of 21 to 59 days, the mean BVF doubled in all investigated arteries compared with 2 to 11.9 hours, with a further significant increase (P < .05) by the age of 150 to 240 days in cerebral and renal arteries. There was no correlation between the mean blood pressure (BP) and mean BFV in the ACA and MCA. However, there was a positive correlation (r ≥ 0.5; P < .05) between the BP and BFV in the RA and SMA at the age of 12 to 23.9 hours. Conclusions. A significant increase in the cerebral and visceral BFV occurs normally throughout infancy, with the visceral BFV affected by BP changes during the first day of life. Key words: cerebral blood flow velocity; neonate; sonography; visceral blood flow velocity. oppler sonography is a noninvasive method that allows repeated and safe assessment of hemodynamics in neonatal units. Several studies have shown that a pulsed Doppler technique can be used to examine the pattern of blood flow velocity (BFV) in major vessels of the brain 1 as well as visceral organs 2 in neonates with good reproducibility. Several studies have followed the BFV in different cerebral 3-6 and visceral 7-11 arteries during cardiovascular adaptation of the neonate within the first week of life. These studies typically evaluated a single organ. A few cross-sectional studies have followed the changes of the cerebral BFV in neonates up to the first 20 days of life 12 and infants older than 30 days. 13,14 Cross-sectional studies of the BFV in renal arteries have also been performed in infants older than 30 days. 7,[15][16][17] To our knowledge there have been no studies looking at the normal preprandial splanchic BFV in infants older than 1 month.

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Section: Discussionmentioning

confidence: 55%

Developmental Changes in Cerebral and Visceral Blood Flow Velocity in Healthy Neonates and Infants

Ilves

Lintrop

Talvik

et al. 2008

Journal of Ultrasound in Medicine

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“…The surge is induced by labor, which is why infants delivered vaginally have considerably higher cord artery and/or cord vein levels of norepinephrine (NE), and/or epinephrine (EPI), than those delivered by elective cesarean section [2][3][4][5]. Catecholamines are essential for postnatal adaptation and contribute to the regulation of cardiac output, blood pressure, thermogenesis, surfactant release, lung liquid production and absorption, as well as the regulation of blood glucose levels [6].…”

Section: Introductionmentioning

confidence: 99%

Arterio-venous differences in cord levels of catecholamines, glucose, lactate and blood gases

Koh

Hume

Eisenhofer

et al. 2016

Journal of Perinatal Medicine

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Background: Norepinephrine (NE) and epinephrine (EPI) levels are higher in cord arterial blood relative to venous blood, consistent with active mechanisms of placentalmaternal clearance. There are no contemporary studies of cord arteriovenous blood levels of sulfated and nonsulfated catechols. Aim: To assess the arteriovenous differences in cord blood levels of dopamine (DA), the sulfated catecholamines and their sulfated and non-sulfated metabolites. To correlate levels of oxygen, H + /CO 2 , and glucose with cord catecholamine levels. Methods: Fifty-seven term infants, delivered by elective cesarean section, were recruited. Cord arterial and venous blood was sampled; levels of glucose, lactate, blood gases, six catechols and their sulfated conjugates were measured. Results: With one exception (DOPA sulfate), mean cord arterial levels of sulfated and non-sulfated catechols were significantly higher than venous levels. Arterial lactate and glucose levels were independently associated with NE levels, but only lactate was associated with levels of EPI and DA. Conclusion: This study establishes that in vivo metabolic parameters of hypoxia, respiratory and metabolic acidosis are associated with catecholamine levels, a key relationship for perinatal adaptation and homeostasis, and findings that are consistent with in vitro studies of the regulators of catecholamine secretion.

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“…The plasma CAs, epinephrine and norepinephrine, play a crucial role at birth in adapting the neonate to extrauterine life by promoting lung maturation, increasing cardiovascular performance, mobilizing glucose, and regulating blood flow to vital organs such as brain (Faxelius et al 1983(Faxelius et al , 1984Sperling et al 1984;Habib et al 1991; Barker and Olver 2002). Several groups have demonstrated that humans born by elective C-section have markedly reduced levels of plasma CAs at birth compared to vaginally born neonates (Irestedt et al 1982;Jones and Greiss 1982;Faxelius et al 1983Faxelius et al , 1984Agata et al 1995;Vogl et al 2006). We and others have previously shown that, similar to findings in humans, plasma CAs at birth are also reduced in rats born by C-section compared to vaginal birth (El-Khodor and Boksa 1997;Ronca et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Epinephrine administration at birth prevents long-term changes in dopaminergic parameters caused by Cesarean section birth in the rat

Boksa

Zhang

2008

Psychopharmacology

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Hemodynamic Adaptations at Birth and Neonates Delivered Vaginally and by Cesarean Section

Cited by 32 publications

References 0 publications

Developmental Changes in Cerebral and Visceral Blood Flow Velocity in Healthy Neonates and Infants

Developmental Changes in Cerebral and Visceral Blood Flow Velocity in Healthy Neonates and Infants

Arterio-venous differences in cord levels of catecholamines, glucose, lactate and blood gases

Epinephrine administration at birth prevents long-term changes in dopaminergic parameters caused by Cesarean section birth in the rat

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