Abstract
Cerebral haemodynamics during the immediate transition period in neonates may differ depending on whether delivery is vaginal or by caesarean section. However, these differences have never been confirmed by near-infrared time-resolved spectroscopy (TRS). Therefore, the purpose of this study was to compare cerebral blood volume (CBV) and cerebral haemoglobin oxygen saturation (ScO2) between healthy term neonates by mode of delivery. Subjects were 31 healthy term neonates who did not require resuscitation. Thirteen neonates were delivered vaginally (VD group) and 18 were delivered by elective caesarean section (CS group). Absolute oxyhaemoglobin, deoxyhaemoglobin, and total haemoglobin concentrations were measured continuously by TRS; oxyHb × 100/totalHb (ScO2) (%) and CBV (mL/100 g brain tissue) were also calculated. Measurements were started as soon as possible after birth, obtained from 1 to 2 min after birth, and continued until 15 min after birth. CBV was significantly higher in the VD group than in the CS group in the 4 min after birth but not thereafter. There were no significant between-group differences in ScO2 and SpO2. These findings indicate that there is a difference in cerebral haemodynamic patterns in the first 4 min after delivery between term neonates by mode of delivery when CBV is monitored by TRS.
Highlights
Cerebral haemodynamics during the immediate transition period in neonates may differ depending on whether delivery is vaginal or by caesarean section
cerebral blood volume (CBV) was significantly higher in the 4 min after birth in the VD group than in the CS group [(Fig. 1A) VD/CS group mean [95% confidence interval (CI)] mL/100 g brain tissue: 1.5 min, 2.8 [2.5–3.0]/2.3 [2.1–2.5]; 2 min, 2.8 [2.6–3.0]/2.3 [2.1–2.5]; 3 min, 2.8 [2.6–3.0]/2.4 [2.1–2.6]; 4 min, 2.7 [2.4–2.9]/2.3 [2.1–2.5]; 5 min, 2.6 [2.3–2.8]/2.3 [2.1–2.5]; 10 min, 2.3 [2.0–2.5]/2.1 [1.9–2.3]; and 15 min, 2.2 [1.9–2.4]/2.0 [1.8–2.2]]
The two main findings of this study were as follows: (1) CBV was significantly higher in the VD group than in the CS group in the first 4 min after delivery but decreased thereafter during the first 15 min in both groups and (2) there was an increase in S cO2 including S pO2, but it was not significantly different between these delivery modes
Summary
Cerebral haemodynamics during the immediate transition period in neonates may differ depending on whether delivery is vaginal or by caesarean section. These differences have never been confirmed by near-infrared time-resolved spectroscopy (TRS). There were no significant between-group differences in ScO2 and SpO2 These findings indicate that there is a difference in cerebral haemodynamic patterns in the first 4 min after delivery between term neonates by mode of delivery when CBV is monitored by TRS. We have previously reported a difference in the pattern of cerebral haemoglobin (Hb) oxygen saturation (ScO2) during the first 15 min after birth according to whether delivery is vaginal or by caesarean section[13,14]. Urlesberger et al found no differences in regional oxygen saturation in the brain according to mode of d elivery[6]
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