The Impact of Delivery Type on Ventricular Performances of Healthy Neonates

Abstract

Objective: The present study aims to evaluate how the mode of delivery affects the alterations in myocar­dial functions of healthy newborns within the first month of life.

study desıgn: This is a prospective review of 60 healthy term newborns whose cardiac functions were examined by M-mode and tissue Doppler echocardiography on the first day of their lives and subsequently at one month of age.

Results: At the first visit, the tricuspid annular plane systolic excursion was significantly higher in vaginally delivered newborns. Mitral and tricuspid E velocities and E/E’ ratio of the right ventricle and isovolumic relaxation time of right ventricle were also significantly higher in newborns delivered by cesarean section. Both of the groups had statistically similar M-mode and tissue Doppler echocardiography measurements at the time of the second visit. Only the increase in the tricuspid A velocity and myocardial performance index measured from septum between the first and second visits were significantly higher in the cesarean delivery group. When compared with the first visit, both isovolumic contraction time and isovolumic relaxation time were lower between the groups but myocardial performance index values were increased without significance at the second visit.

Conclusion: Diastolic indices were significantly elevated in newborns delivered by cesarean section than neonates delivered by vaginal route. After one-month-long follow up, an increase was observed in diastolic ventricle functions of the vaginally delivered newborns but this increase was statistically insignificant. Cesarean delivery might be associated with the impairment in ventricular functions and, thus, a delay in the improvement and maturation of cardiac functions.