Birth is a complex physiological process where several cardio-pulmonary adaptations occur for a fetus to change from a high pressure intra-uterine to a low pressure extra-uterine pulmonary ‘circuit’. Although most babies undergo this process successfully, a significant proportion suffers from ‘failure’ or ‘delay’ in transition. This is a very common reason for newborn babies to need intensive care treatment and in its most severe form, which is said to occur in 4 to 10% of admissions in tertiary intensive care facilities, carries a high risk of death. Even though this disease and associated complications is a common occurrence during the neonatal period, currently no tools are available for clinicians to objectively diagnose or monitor disease progression. Further, the underlying determinants for adverse outcomes are poorly described. My research program is focused on improving the current ‘state of affairs’ for this population. This research primary involves studying human babies with the use of high resolution ultrasound (echocardiography), which is the only clinically feasible investigation in babies. Using longitudinal functional echocardiographic evaluations, I am looking to describe cardio-pulmonary hemodynamic changes associated with normal birth in well babies and generate clinically applicable normative data. Further, using the same methodology, I am studying the relevance of right heart function as a determinant of adverse outcomes in babies who suffer from pathological alternations in postnatal transition. This includes studying the use of new echocardiography methods to quantify right heart function as well as establish normative data for further comparison with disease population.