Postnatal rearrangement of central hemodynamics in surgically born babies

Abstract

Objective: to investigate the impact of complicated ante- and intranatal periods on postnatal cardiovascular hemodynamic adaptation in surgically born babies who have suffered hypoxia-ischemia. Patients and methods. A total of 382 full-term neonatal infants were examined. A study group included 117 cesarean born babies who had suffered hypoxia-ischemia. Comparison Group 1 comprised 150 infants who had been born by cesarean section and had no signs of cerebral ischemia. Comparison Group 2 consisted of 65 vaginally born babies following hypoxia-ischemia. A control group included 50 infants of physiological pregnancy and labor. In the first 1—2 days of life, all the neonates underwent EchoCG and determination of structural and hemodynamic parameters by using the standard procedures. Impaired postnatal hemodynamic rearrangement was found in all the babies of the examined groups, particular in those who had been born via cesarean section and sustained hypoxia-ischemia; the magnitude of disadaptation correlated with the severity of hypoxia-ischemia. A delayed reduction of dysfunction beyond the early neonatal period was noted in babies exposed to a combination of perinatal damaging factors. Conclusion. A set of poor ante- and intranatal factors contributes to impaired cardiac hemodynamic adaptation. The babies who have been born via cesarean section and sustained hypoxia-ischemia constitute a group at risk for cardiac abnormality in different age periods.