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The newborn transitional circulation: a two-dimensional Doppler echocardiographic study.

L T Mahoney, K G Coryell, R M Lauer

    Journal of the American College of Cardiology
    |September 1, 1985
    PubMed
    Summary
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    This study tracked circulation changes in newborns using echocardiography. Patent ductus arteriosus and tricuspid insufficiency were common in the first few days after birth, with velocities normalizing over time.

    Area of Science:

    • Neonatal circulation
    • Pediatric cardiology
    • Echocardiography

    Background:

    • Postnatal circulatory transition is complex.
    • The patent ductus arteriosus (PDA) and tricuspid insufficiency are common in neonates.

    Purpose of the Study:

    • To characterize circulatory changes in normal newborns during the first 72 hours of life.
    • To establish normal Doppler velocity profiles in great arteries and across valves.
    • To identify the incidence of PDA and tricuspid insufficiency in healthy neonates.

    Main Methods:

    • Two-dimensional and pulsed Doppler echocardiography were used.
    • 11 healthy, full-term infants were studied serially for 3 days post-delivery.
    • Measurements included pulmonary artery and descending aorta velocities, and tricuspid valve flow.

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    Main Results:

    • Retrograde diastolic pulmonary artery velocities (PDA evidence) decreased from 91% on day 1 to 0% on day 3.
    • Retrograde systolic descending aorta velocities decreased from 91% on day 1 to 64% on day 3.
    • Tricuspid insufficiency was observed in 55-73% of infants during the first 3 days.

    Conclusions:

    • Physiologic closure of the PDA occurs within 3 days of birth.
    • Tricuspid insufficiency is a frequent finding in healthy newborns.
    • Normal Doppler velocity data are provided for comparison with congenital heart defects.