Delayed lung liquid absorption after cesarean section at term

Neonatology. 2013;104(2):133-6. doi: 10.1159/000351290. Epub 2013 Jul 24.


Background: Delayed postnatal removal of lung liquid may result in respiratory distress, which is more common in infants born by cesarean section. Vertical artefacts (B-lines) arising from the lung surface in lung ultrasound have been shown to correlate with the liquid content of the lungs.

Objectives: We studied whether lung ultrasound could be used for the assessment of postnatal lung liquid in healthy term infants born vaginally and by cesarean section.

Methods: Lung ultrasound was performed 1, 3 and 24 h after birth to 22 vaginally born infants and 20 infants born by elective cesarean section. The abundance of B-lines was scored for each infant and time point by two independent observers blinded to the mode of delivery and time point on the examination on a five-step scale.

Results: In both groups, a significant decrease in abundance of B-lines, indicative of lung liquid absorption, was observed during the first 24 h. 3 h after birth cesarean section was associated with significantly higher lung liquid content than vaginal delivery.

Conclusion: The noninvasive bedside ultrasound method for estimation of lung liquid is a promising tool for the early identification of infants at risk for pulmonary maladaptation.

MeSH terms

  • Absorption
  • Biological Transport
  • Body Fluids / metabolism*
  • Cesarean Section*
  • Female
  • Gestational Age
  • Humans
  • Linear Models
  • Lung / diagnostic imaging*
  • Lung / metabolism*
  • Male
  • Observer Variation
  • Point-of-Care Systems
  • Predictive Value of Tests
  • Pregnancy
  • Reproducibility of Results
  • Term Birth*
  • Time Factors
  • Ultrasonography
  • Video Recording