The impact of mode of delivery on intestinal wall microvascularity in healthy newborns is studied using Superior Microvascular Imaging Doppler technique

M any important adjustments occur in newborns during the shift from the fetal period to neonatal life.The most urgent processes in the neonatal transition are the initiation of air breathing and the remodeling of the circulatory system to a postnatal circulation [1-3].Hemodynamic postnatal adaptation may be different in infants born by cesarean section (C/S) and those born through normal spontaneous vaginal delivery (NSVD).The concentrations of umbilical artery adenosine and catecholamine have been found to differ significantly between NSVD and C/S [4], suggesting that early neonatal cardiovascular patterns may differ according to the delivery mode [5].However, studies conducted on healthy term infants are limited, and it has been shown ABSTRACT OBJECTIVE: This study aimed to investigate whether the mode of delivery influences intestinal microperfusion in healthy term neonates and to evaluate the utility of Superb Microvascular Imaging (SMI) in assessing neonatal intestinal microcirculation.METHODS: A total of 45 healthy term neonates born between 38 and 40 weeks of gestation were prospectively enrolled.Twenty-six infants were delivered by cesarean section (C/S) and 19 by normal spontaneous vaginal delivery (NSVD).Intestinal microperfusion was assessed within the first 48 hours of life using monochrome SMI (mSMI) and color SMI (cSMI).Conventional Doppler techniques, including Color Doppler Imaging (CDI), Power Doppler Imaging (PDI), and Advanced Dynamic Flow (ADF), were also performed.Intestinal vascularity was semi-quantitatively scored and compared between groups. RESULTS:No significant difference in intestinal microperfusion was observed between neonates delivered by C/S and NSVD using either mSMI (p=0.507) or cSMI (p=0.720).Similarly, no significant differences were detected using CDI, PDI, or ADF.However, mSMI demonstrated significantly higher detection of intestinal vascularity compared to cSMI (p