“A full-term newborn female develops respiratory distress 1 hour after an uncomplicated caesarean delivery. She has a respiratory rate of 70/min, and mild grunting and intercostal retractions are noted on examination. The remainder of the examination is within normal limits. A chest radiograph shows some hyperexpansion and fluid in the fissures.

What is the most likely cause of her symptoms? Answer: Transient tachypnea of the newborn

“This patient has transient tachypnea of the newborn, which typically occurs within 2 hours of birth. The chest radiograph usually shows hyperexpansion with perihilar densities and fluid within the fissures. Respiratory distress syndrome of the newborn is most often seen in premature infants, and the chest radiograph shows a classic diffuse ground-glass appearance. With pneumothorax a chest radiograph would

typically show a partial or complete lung collapse. Meconium aspiration syndrome occurs in the setting of meconium-stained fluid and is usually apparent immediately after delivery. The chest radiograph typically shows fluffy densities with hyperinflation.“ABFM

Reference

Newborn respiratory distress. Am Fam Physician 2015;92(11):994-1002.

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