Electrical impedance tomography confirmed the impact of the method of delivery of term neonates on early lung aeration

Adomas Janulionis; Viktorija Sutova; Vita Langiene; Ernestas Virsilas; Violeta Drejeriene; Arunas Liubsys; Arunas Valiulis

doi:10.17219/acem/190742

Electrical impedance tomography confirmed the impact of the method of delivery of term neonates on early lung aeration

Adv Clin Exp Med. 2025 Jan 27. doi: 10.17219/acem/190742. Online ahead of print.

Authors

Adomas Janulionis¹, Viktorija Sutova¹, Vita Langiene², Ernestas Virsilas^{1

3}, Violeta Drejeriene², Arunas Liubsys^{1

3}, Arunas Valiulis¹

Affiliations

¹ Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Lithuania.
² Obstetrics and Gynecology Clinic, Vilnius City Clinical Hospital, Lithuania.
³ Centre of Neonatology, Vilnius University Hospital Santaros Clinics, Lithuania.

PMID: 39868740
DOI: 10.17219/acem/190742

Abstract

Background: The number of infants born via cesarean section (CS) is increasing globally due to medical and cultural reasons.

Objectives: This study aimed to determine the effect of the mode of delivery on early lung aeration in newborns using electrical impedance tomography (EIT).

Material and methods: The case-control study was conducted from December 2020 to April 2021. It included 32 term neonates delivered by CS and 20 term neonates delivered by normal vaginal delivery (NVD) as controls. Electrical impedance tomography examinations were performed with a Swisstom BB2 device with NEO SensorBelt and 32 integrated electrodes at 47.68 Hz. Three data recordings were conducted within 30, 60 and 90 min (mean times: 13, 62 and 93 min, respectively) after the birth.

Results: Cesarean section neonates, compared to those delivered by NVD, had greater non-aerated areas in gravity-dependent lung regions at the 2nd recording (p = 0.04). The CS group showed lower changes in lung stretch at the 2nd and 3rd recording compared to the NVD group (p = 0.022 and p = 0.032, respectively). In the study group, lung regions with the lowest stretch (10-20%, 20-30% and 30-40%) corresponded with increased total lung capacities 1 h after birth compared to the control group (p = 0.024, p = 0.004 and p = 0.044, respectively). Measurements from the 1st and 3rd EIT recording showed a greater distribution of tidal volume (TV) in the right lung toward the central regions among CS neonates compared to NVD neonates, whereas NVD neonates showed increased distribution of TV toward the central-ventral regions of the right lung immediately after birth.

Conclusions: The mode of delivery significantly affects early postnatal lung aeration in term neonates assessed using EIT. Caesarean section neonates were characterized by poorer aeration in gravity-dependent lung regions, whereas NVD neonates demonstrated greater changes in lung stretch and more intense tissue expansion, potentially leading to better postnatal adaptation.

Keywords: cesarean section; electrical impedance tomography; lung aeration; normal vaginal delivery; term neonates.