Neonatal Circulatory Changes Following Elective Cesarean Section: An Echocardiographic Study

PEDIATRICS ◽  
1982 ◽  
Vol 69 (3) ◽  
pp. 374-376
Author(s):  
Mark D. Jacobstein ◽  
Stephen S. Hirschfeld ◽  
Celia Flinn ◽  
Thomas Riggs ◽  
Avroy Fanaroff
Keyword(s):  
Cesarean Section ◽  
Right Ventricular ◽  
Diastolic Pressure ◽  
Systolic Time Intervals ◽  
Elective Cesarean Section ◽  
Ejection Time ◽  
Elective Cesarean ◽  
Systolic Time ◽  
The Right ◽  
Ventricular Ejection Time

Right ventricular systolic time intervals have been used in neonates to demonstrate both normal and abnormal cardiovascular adaptation to extrauterine life.1,2 The ratio of these intervals, which include the right ventricular preejection period (RVPEP) and right ventricular ejection time (RVET), correlates closely with pulmonary vascular resistance (PVR) and pulmonary artery diastolic pressure.3 Previous echocardiographic studies in normal newborns have demonstrated the decline in PVR, but have excluded babies delivered by cesarean section (CS).1 Many respiratory abnormalities are noted following both elective and emergency CS. These are attributed to respiratory distress syndrome, transient tachypnea of the newborn (TTN), aspiration syndromes, and persistent fetal circulation (PFC).4-9

Neonatal Circulatory Changes: An Echocardiographic Study

PEDIATRICS ◽  
1977 ◽  
Vol 59 (3) ◽  
pp. 338-344
Author(s):  
Thomas Riggs ◽  
Stephen Hirschfeld ◽  
Connie Bormuth ◽  
Avroy Fanaroff ◽  
Jerome Liebman
Keyword(s):  
Right Ventricular ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ejection Time ◽  
Time Intervals ◽  
Systolic Time ◽  
The Right ◽  
Ventricular Ejection Time

Serial echocardiograms were performed in the first three days of life on 38 normal full-term infants. Right ventricular systolic time intervals were measured from the pulmonic valve echogram and left ventricular systolic time intervals were determined from the aortic valve echogram. The heart rate, left ventricular pre-ejection period (LPEP), left ventricular ejection time (LVET), and LPEP/LVET ratio showed insignificant variation with increasing postnatal age. The right ventricular pre-ejection period (RPEP) shortened, the right ventricular ejection time (RVET) lengthened, and the RPEP/RVET ratio decreased with increasing age. The findings suggested that alterations in the RPEP/RVET ratio reflected the decreasing pulmonary artery diastolic pressure and pulmonary vascular resistance of the early neonatal period and may be valuable in the noninvasive evaluation of the newborn's pulmonary vascular bed.

Value of Systolic Time Intervals in the Diagnosis of Large Patent Ductus Arteriosus in Fluid-Restricted and Mechanically Ventilated Preterm Infants

PEDIATRICS ◽  
1984 ◽  
Vol 74 (6) ◽  
pp. 1069-1074
Author(s):  
François Heitz ◽  
Jean-Claude Fouron ◽  
Nicolaas H. van Doesburg ◽  
Harry Bard ◽  
François Teasdale ◽  
...  
Keyword(s):  
Patent Ductus Arteriosus ◽  
Right Ventricular ◽  
Ductus Arteriosus ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Ejection Time ◽  
Time Intervals ◽  
Systolic Time ◽  
Ventricular Ejection Time ◽  
Patent Ductus

M-mode echocardiographic features suggesting a patent ductus arteriosus are based on two groups of indirect criteria: dilation of the left cardiac cavities and changes of systolic time intervals. The reliability of the first group of criteria has been questioned in fluidlimited, mechanically ventilated preterm infants. The sensitivity of the systolic time intervals in the same circumstances is investigated. Twenty-three patients with a large patent ductus arteriosus were selected. Review of their echocardiograms shows that the sensitivity of the various criteria (expressed as percentage of positivity) was as follows: inversion of the ratio of left ventricular preejection period to right ventricular preejection period, 91.3%; left ventricular preejection period to left ventricular ejection time over right ventricular preejection period to right ventricular ejection time < 1, 83%; left atrium dilation, 74%; shortening of left ventricular preejection period, 70%; dilation of left ventricular internal dimensions in diastole, 65%; increase in left atrium/aorta, 52%; and decrease of left ventricular preejection period to left ventricular ejection time, 48%. Three criteria involving time intervals (left ventricular preejection period to right ventricular preejection period, left ventricular preejection period, and left ventricular preejection period to left ventricular ejection time) had 100% specificity. The lowest specificity was found with criteria involving the left atrium (left atrial to aortic root ratio 75% and left atrium 63%). It is concluded that study of systolic time intervals is a reliable means of detecting preterm infants with hemodynamically significant left-to-right shunt through a patent ductus arteriosus even if the infants are mechanically ventilated and fluid restricted.

Echographic Ventricular Systolic Time Intervals in Normal Term and Preterm Neonates

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 317-321
Author(s):  
Henry Halliday ◽  
Stephen Hirschfeld ◽  
Thomas Riggs ◽  
Jerome Liebman ◽  
Avroy Fanaroff
Keyword(s):  
Right Ventricular ◽  
Preterm Infants ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Ejection Time ◽  
Time Intervals ◽  
Normal Term ◽  
Systolic Time ◽  
Ventricular Ejection Time

Right ventricular and left ventricular systolic time intervals (RVSTIs and LVSTIs) were measured in normal term and preterm infants from 1 hour to 90 days of life. LVSTIs in both term and preterm infants were similar in the first five days of life. The ratio of left pre-ejection period (LPEP) to left ventricular ejection time (LVET) was lower in preterm infants older than age 5 days. Estimated gestational age had no influence on LVSTI. The ratio of right preejection period (RPEP) to right ventricular ejection time (RVET) was lower in preterm infants (0.32) than in term newborns (0.37). The preterm RPEP/RVET ratio decreased with age, but at a slower rate than in term babies. This was consistent with the lower pulmonary vascular resistance present in preterm infants.

scholarly journals Hemodynamic effects of right pelvic wedge in patients undergoing elective cesarean section under spinal anesthesia

2018 ◽  
Vol 1 (2) ◽  
pp. 70-74
Author(s):  
Rohini Sigdel ◽  
Maya Lama ◽  
Sanish Gurung ◽  
Bishal Gurung ◽  
Anil Prasad Neupane ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Operating Table ◽  
Hemodynamic Effects ◽  
Elective Cesarean ◽  
Spinal Hypotension ◽  
The Right

Background: Several methods have been used to prevent post spinal hypotension including preloading, co-loading, use of vasopressors, placement of pelvic wedge, lumbar wedge and tilting of operating table in parturients undergoing cesarean section. We conducted a randomized controlled study to determine the hemodynamic effects of a standard pelvic wedge placed below the right hip immediately after the spinal block till the delivery of baby. Methods: One hundred consenting women undergoing elective cesarean section under spinal anesthesia were randomly allocated to wedge group (N=50) and control group (N=50). A standard wedge was placed under the right pelvis soon after spinal anesthesia till the delivery of baby in wedge group whereas the control group remained supine. Hemodynamic parameters including blood pressure, heart rate, vasopressor consumption, other side effects like nausea, vomiting and neonatal outcome were also recorded. Results: The incidence of hypotension and bradycardia was similar between groups (Wedge group 60% vs Control group 75.51%, p=0.125) before the birth of baby. The use of vasopressors (p=0.212), incidence of nausea (p=0.346) and Apgar score at 1 and 5 minutes (p=0.629, p=0.442) were also not statistically significant. None of the patients had vomiting. Conclusion: In our study, the use of right pelvic wedge immediately after spinal anesthesia was not effective in preventing post spinal hypotension in elective cesarean section.

scholarly journals Cesarean Section and Right Femur Fracture: A Rare but Possible Complication for Breech Presentation

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Giampiero Capobianco ◽  
Giuseppe Virdis ◽  
Pietro Lisai ◽  
Claudio Cherchi ◽  
Ornella Biasetti ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Femur Fracture ◽  
Traumatic Injury ◽  
Breech Presentation ◽  
Complete Healing ◽  
Elective Cesarean Section ◽  
Elective Cesarean ◽  
Abdominal Route ◽  
Breech Extraction ◽  
The Right

Background. The breech extraction of the fetus through the vagina has a greater risk of hip fracture compared with the extraction by abdominal route.Case. A 2390 g female infant was delivered at 39 weeks by elective cesarean section for breech presentation. The newborn sustained a fracture of the right femur. A simple immobilization of the limb in extension led to a complete healing of the fracture without sequelae.Conclusion. Caesarean delivery reduces the risk of causing a traumatic injury of the newborn compared to vaginal delivery, especially with breech presentation but does not eliminate this possible accidental complication.

Systolic time intervals during +Gz acceleration

1976 ◽  
Vol 41 (1) ◽  
pp. 52-56 ◽  
Author(s):  
T. B. Graboys ◽  
E. D. Michaelson
Keyword(s):  
Recovery Period ◽  
Systolic Time Intervals ◽  
Cardiovascular Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ejection Time ◽  
Time Intervals ◽  
Physiological Variables ◽  
Systolic Time ◽  
Ventricular Ejection Time

Systolic time intervals (STI) were recorded in 8 healthy male volunteersbefore, during, and after 30-s exposures to +3 Gz, +5 Gz, and +7 Gz acceleration. Heart rate (HR) increased at all +Gz levels, as did the HR correctedQSIc interval, left ventricular ejection time (LVETc), preejection period (PEPc) and PEP/LVET. These changes in STI were also proportional to the +Gz level. At the higher +Gz levels, PEPc and PEP/LVET continued to increase early in the recovery period, but HR and all STI returned to control after 60s of recovery. Although physiological variables other than myocardial contractility, such as preload and afterload may influence STI during +Gz the effects of +Gz on stroke volume (SV) and cardiac output (CO) were estimated using previously described relationships between STI and invasively determined indices of cardiovascular function. In general CO increased as SV decreased. During recovery, HR and CO fell and CO remained slightly below controllevels, primarily because estimated SV remained low. This study demonstrates the feasibility of using STI to estimate noninvasively the transient changes in cardiovascular function during +Gz acceleration.

Value of Echocardiography in Assessing the Outcome of Bronchopulmonary Dysplasia of the Newborn

PEDIATRICS ◽  
1980 ◽  
Vol 65 (3) ◽  
pp. 529-535 ◽  
Author(s):  
Jean-Claude Fouron ◽  
Jean-Claude Le Guennec ◽  
Didier Villemant ◽  
Harry Bard ◽  
Gilles Perreault ◽  
...  
Keyword(s):  
Bronchopulmonary Dysplasia ◽  
Myocardial Function ◽  
Systolic Time Intervals ◽  
Pulmonary Insufficiency ◽  
X Rays ◽  
Ejection Time ◽  
Time Intervals ◽  
Time Ratio ◽  
Systolic Time ◽  
The Right

Cardiac catheterization of infants with bron-chopulmonary dysplasia has shown right ventricular hypertrophy and pulmonary hypertension in the majority of the survivors. This study was planned to determine whether serial echocardiographic assessments of the pulmonary vascular bed could help to establish short-term prognosis of bronchopulmonary dysplasia and to evaluate myocardial function of the survivors. Ten preterm infants were included in this study. They were classified according to four radiologic stages. A total of 50 echocardiographs were recorded allowing serial measurements of the right systolic time intervals. All infants that eventually expired had a ratio of the preejection period to the ejection time of the right ventricle above 0.3 prior to death (five patients). Infants with normal right preejection period to right ejection time ratio had a good out-come despite persistence of abnormal lung x-rays (four patients). Persistence of O2 dependence with abnormal right systolic time intervals after three months of life eventually led to death (two patients) or serious pulmonary insufficiency (one patient). The lungs as seen on chest x-rays of this patient remained unchanged (moderate stage IV) during six months, while the echocardiograph showed a progressive increase in right preejection period to right ejection time ratio. This infant has now developed cor pulmonale. Myocardial function evaluated on the last echocardiograph of the four infants who were considered cured was within normal limits. In conclusion, indirect assessment of pulmonary pressure by echocardiography can be used for clinical evaluation and ultimate prognosis of bronchopulmonary dysplasia and should be part of the follow-up evaluation of infants suffering from this disease.

SYSTOLIC TIME INTERVALS (STI) AS INDICATORS OF MYOCARDIAL THYROID HORMONE EFFECT

1978 ◽  
Vol 87 (3) ◽  
pp. 507-515 ◽  
Author(s):  
J. Chakravarty ◽  
A. R. Guansing ◽  
S. Chakravarty ◽  
C. V. Hughes
Keyword(s):  
Thyroid Hormone ◽  
Systolic Time Intervals ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ejection Time ◽  
Time Intervals ◽  
Left Ventricular Ejection Time ◽  
Hormone Effect ◽  
Systolic Time ◽  
Ventricular Ejection Time

ABSTRACT Systolic time intervals consisting of indices of electromechanical systole (QS2-I), left ventricular ejection time (LVET-I) and pre-ejection period (PEP-I) were calculated serially during therapy in 12 euthyroid, 9 hypothyroid and 9 hyperthyroid individuals. These parameters were analyzed sequentially together with the changes in serum thyroxine (T4), triiodothyronine (T3) and thyrotrophin (TSH) in order to determine the sensitivity of these non-invasive procedures in monitoring peripheral thyroid hormone effect. The results are expreseed in mean ± sem. QS2-I (506.3 ± 8.2 ms) and PEP-I (102.9 ± 4.2) were shortened (P < 0.02 and P < 0.001, respectively) in hyperthyroidism and prolonged (579.3 ± 7.3 and 169.6 ± 3.6 ms) in hypothyroidism (P < 0.01 and P < 0.001, respectively) compared to euthyroid controls (538.1 ± 8.8 and 130.3 ± 5.3 ms), while LVET-I did not change significantly in either condition. Simultaneous determinations of circulating T4, T3 and TSH showed changes appropriate to both hypo- and hyperthyroid states. In 2 patients with T3-thyrotoxicosis, PEP-I was decreased to an average of 103.1 ms, while in 2 patients with compensated hypothyroidism (normal T4 but elevated TSH) this was prolonged to 163.7 ms (average) compared to euthyroid controls. During treatment the hypothyroid group showed significant sequential correlation of TSH and PEP-I. In the hyperthyroid individuals, PEP-I correlated significantly with T4 and T3. PEP-I may be a useful, sensitive, quantitative biologic indicator of thyroid hormone effect on myocardial function.

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