Does the Type of Anesthesia Applied in Non-Emergency Cesarean Section Affect the Ultrasound Image of the Newborn Baby's Lungs?

Lung ultrasonography will be performed within the first 10-20 minutes of life after the first care of the newborn. In the evaluation of the lung by ultrasonography, the lung ultrasonography score, which has been validated by various studies in the adult and pediatric population, will be used. In this scoring system, both lungs are evaluated and the scores given are summed and the lung ultrasound score is obtained. Basically, each lung is divided into 3 areas (upper anterior, lower anterior and lateral) and both transverse and longitudinal scans are performed. For this, a 6-13 megahertz linear probe is used. A score of 0-3 points is given for each lung area (total score is between 0-18). A score of 0 is given for areas with only the presence of A lines, 1 for areas with the presence of 3 or more well-spaced B lines, 2 points for areas with the presence of crowded and combined B lines with or without consolidations limited to the subpleural space, and 3 points for areas with extensive consolidations. . Lines A represent the reflection of the pleura in an air-filled lung, while lines B represent the interstitium and the fluid that fills the alveolar space if they join. Measurements will be made by a trained anesthesiologist. The anesthesiologist who will make the measurement will not know which type of anesthesia is used in the cesarean section and will not be responsible for evaluating the clinical data (Apgar scores, respiratory distress findings) of the babies. For this, lung ultrasonography will be performed in a different room, not in the delivery room where the baby is first cared for. Gestational age, birth weight, gender, 1st and 5th minute Apgar scores of all babies, what minute of life the lung ultrasonography was performed, the indication for cesarean section (previous cesarean section history, malpresentation, macrosomia suspicion, other), the onset of anesthesia-skin incision time ( initiation of iv injection of propofol for general anesthesia, administration of local anesthetic into the CSF for spinal anesthesia), skin incision-uterine incision time, beginning of anesthesia-uterine incision time, skin incision-cord clamping time, uterine incision-cord clamping time, beginning of anesthesia-cord clamping time, the presence of neonatal asphyxia, whether there is crying at birth, and whether there is a need for resuscitation will be noted. The presence of at least one of the signs of >60 breaths/min, tachycardia 160 beats/min, supraclavicular or intercostal retraction, nasal wing breathing, wheezing in the expiration, hypoxia (<85% saturation in room air) in infants will be considered clinically as respiratory distress and within 30 minutes. If there is no improvement, the baby will be taken to the neonatal intensive care unit. Postnatal stabilization will be performed by a non-study resuscitation team (pediatrician and nurse) and according to current neonatal resuscitation guidelines. APGAR scores, respiratory distress, neonatal asphyxia and hearth rate will be assessed using physical examination and oxygen saturation on pulse oximetry. Lung ultrasonography score will be assessed at 10-20 minutes post-birth and will take approximately 5 minutes to complete. APGAR scores will be assessed at 1 and 5 minutes post-birth. All other observations will occur once only within 24 hours of birth, and will take approximately 30 minutes to complete.