Right-to-left shunting in the ductus arteriosus is induced readily by intense crying and rapid postural change in neonates with meconium-stained amniotic fluid*

Baba, Atsushi; Ishida, Takanobu; Okada, Mayumi; Akazawa, Yohei; Hirabayashi, Kanae; Saida, Ken; Sakaguchi, Kesami; Koike, Kenichi

doi:10.1097/pcc.0b013e3182191a35

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…Also, Dinwiddie et al [15] demonstrated in 1- to 3-day-old infants with respiratory distress syndrome that the cry resembles a Valsalva maneuver with a decrease in systemic blood pressure. It has been described that a Valsalva maneuver increases the pulmonary blood pressure [9]. Although we studied infants with healthy lungs in transition, it is probable that an increase in the RtoL DA shunt occurs during the expiratory phase of crying.…”

Section: Discussionmentioning

confidence: 99%

“…There is little data on the effect of crying on hemodynamics during the fetal to newborn transition. Baba et al [9] observed an increase pre-post ductal difference in oxygen saturation during crying in infants with meconium aspiration syndrome several hours after birth, which may indicate that crying influences the DA shunt for up to several hours after birth.…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Crying on the Ductus Arteriosus Shunt and Left Ventricular Output at Birth

Vonderen¹,

Roest

Walther³

et al. 2014

Neonatology

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Background: During neonatal transition, ductus arteriosus (DA) flow changes from right-to-left to left-to-right and contributes considerably to the increase in pulmonary blood flow. Large transpulmonary pressures generated by crying at birth can influence the DA shunt. Objective: This study aimed to assess differences in DA shunt during quiet breathing and crying directly after birth. Methods: In healthy term infants born by caesarean section, echocardiography was performed at 2, 5 and 10 min after birth. The velocity time integral of DA flow, DA flow ratio (right-to-left/left-to-right flow) and left ventricular output were assessed using echocardiography. Shunting was compared within each patient during crying and quiet breathing, and between time points. Results: A total of 23 infants were studied. The velocity time integral of left-to-right shunting was significantly larger during the inspiratory phase of crying than during quiet breathing [12.8 (9.2-17.4) vs. 5.9 (3.9-7.7) cm at 2 min, p < 0.0001; 14.3 (11.5-22.3) vs. 6.7 (4.1-11.1) cm at 5 min, p < 0.0001, and 18.6 (14.8-22.5) vs. 6.7 (4.4-10.7) cm at 10 min, p < 0.0001, after birth]. The increase in left-to-right shunting during crying was independent from the cardiac cycle as the QRS start of shunt interval time was 138 (82) ms during crying and 156 (35) ms during quiet breathing (n.s.). The DA flow ratio was lower in infants who cried at 0-1 time points versus those who cried at 2-3 time points (n.s.) out of the 3 time points measured. Left ventricular output was higher in infants who cried at 2-3 time points versus 0-1 time points (n.s.). Conclusion: Crying at birth significantly influences the DA shunt during transition. © 2014 S. Karger AG, Basel

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Influence of Crying on the Ductus Arteriosus Shunt and Left Ventricular Output at Birth

Vonderen¹,

Roest

Walther³

et al. 2014

Neonatology

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“…Crying is a distress signal (Christensson, Cabrera, Christensson, Uvnas-Moberg, & Winberg, 1995), probably elicited by sudden bright light (babies born in the dark hardly cry), and prolonged by maternal-neonate separation (Michelsson, Christensson, Rothganger, & Winberg, 1996). Crying is not helpful for breathing, rather the opposite as it restores the fetal circulation (Baba et al, 2012;Ludington-Hoe, Cong, & Hashemi, 2002). Transition to extrauterine life begin in the first seconds of life, and includes an array of physiological adjustments, including using the lungs for the first time.…”

Section: Distinguishing Nurturescience From Neurosciencementioning

confidence: 99%

Nurturescience versus neuroscience: A case for rethinking perinatal mother–infant behaviors and relationship

Bergman

Ludwig

Westrup

et al. 2019

Birth Defects Research

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Behavioral and emotional outcomes for babies who experienced maternal separation due to prematurity or birth defects have not improved significantly for the last 20 years. Current theories and treatment paradigms based on neuroscience have not generated explanatory mechanisms that work, or provided testable hypotheses. This article proposes a new field of scientific investigation, “nurturescience” within which new hypotheses can be tested with novel instruments. Key distinctions between neuroscience and nurturescience are described. Our definition of nurturescience is based on the basic needs of all newborns and of the needs of mothers and their families. This understanding is drawn from biology, anthropology, sociology, physiological, and clinical research. Mechanisms are described from studies on microbiota, epigenetics, allostasis, brain imaging, and developmental origins of health and adult disease. The converging message from these and other fields is that the mother–infant dyad should not be separated. Ongoing emotional connection is the cornerstone of development, leading to life‐long resilience. This has implications for making the correct diagnosis (emotional disconnection vs. attachment disorder), providing the appropriate care (infant and family centered developmental care) in the biologically expected place (skin‐to‐skin contact), and potential for rehabilitation (calming cycle theory). Nurturescience has particular relevance to the care of “small and sick” infants, with profound potential for decreasing the “likelihood of developing developmental problems.”

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What can we learn from pulse oximetry of the newborn in the delivery room?*

Vidyasagar¹,

Bhandankar²

2012

Pediatric Critical Care Medicine

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Right-to-left shunting in the ductus arteriosus is induced readily by intense crying and rapid postural change in neonates with meconium-stained amniotic fluid*

Cited by 3 publications

References 19 publications

The Influence of Crying on the Ductus Arteriosus Shunt and Left Ventricular Output at Birth

The Influence of Crying on the Ductus Arteriosus Shunt and Left Ventricular Output at Birth

Nurturescience versus neuroscience: A case for rethinking perinatal mother–infant behaviors and relationship

What can we learn from pulse oximetry of the newborn in the delivery room?*

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