Changes in cerebral oxygenation during early postnatal adaptation in newborns delivered by vacuum extraction measured by near-infrared spectroscopy.
BACKGROUND
Newborns delivered by vacuum extraction quite often show clinical signs of a hemodynamic compromise, which is difficult to assess in terms of severity. The conventional means to measure the hemodynamic status are not sensitive enough to appreciate the severity of general, and more specifically of cerebral circulatory imbalance. The aim was to study cerebral tissue oxygenation during postnatal adaptation in these infants using near-infrared spectroscopy.


METHODS
The tissue hemoglobin index (THI), tissue oxygenation index (TOI), arterial oxygen saturation (pre-ductal SaO₂) and heart rate (HR) were recorded immediately after birth, and again after 12-24 hours of life in 15 newborns delivered by vacuum extraction due to fetal distress. A comparison with 19 healthy newborns delivered by elective cesarean section was performed.


RESULTS
Newborns delivered by vacuum extraction had significantly higher THI 10 to 15 minutes after birth. TOI and HR were significantly higher in the first 5 min and SaO₂ in the first 10 minutes but then did not differ from those after cesarean section.


CONCLUSIONS
Infants delivered by vacuum extraction following fetal distress show transient deviations in cerebral oxygenation and perfusion after birth which were not detectable after 24 hours.
Tanja
T
Karen
Martin
M
Wolf
Rahel
R
Nef
Daniel
D
Haensse
Hans Ulrich
HU
Bucher
Gabriele
G
Schulz
Division of Neonatology, Department Obstetrics & Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, Zurich CH-8091, Switzerland. jean-claude.fauchere@usz.ch.
Jean-Claude
JC
Fauchère
D001784:Blood Gas Analysis; D001921:Brain / Q000378:metabolism*; D005316:Fetal Distress / Q000601:surgery; D006339:Heart Rate; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D010100:Oxygen / Q000378:metabolism*; D019265:Spectroscopy, Near-Infrared; D013997:Time Factors; D014620:Vacuum Extraction, Obstetrical
D006454:Hemoglobins; D010100:Oxygen