Transient Tachypnea of the Newborn TTN
Respiratory distress shortly after birth of a newborn with rapid resolution in 3-4 days
It occurs in 1% of deliveries.
It increases by 4% in CS deliveries
Function of the lung needs
Clearance of fetal lung fluid. -establishment of spontaneous breathing
Decrease in pulmonary vascular resistance
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Release of surfactant
Cessation of the right-to-left shunting of venous blood returning to the heart
Predisposing factors
1-CS
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2-Perinatal Asphyxia.
3-Excessive maternal analgesia.
4-Hypothermia.
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5-Maternal DM and asthma.
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6-Larg baby
7-Delayed clamping of the U.cord 8-Breech delivery.
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9-Fetal polycythemia
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10-Maternal drug abuse.
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11-Precipitate labour.
12-Multiple gestation. Respiratory distress signs may not be prominent.
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Clinical presentation
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Tachypnea>60/min.
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Term or near term baby.
Grunting.
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Cyanosis.
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Edema
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Diagnosis:CXR:
A-Hyperinflation.
B-Perihiler opacities.
C-Fluid in the transverse fissure.
D-Small pleural effusion.
E-Moderately enlarged heart.
Management
Oxygen for 2-3 days concentration more than 40% is rarely needed,sometimes
>60%.
CPAP
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Feeding:Oral if RR<60
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Antibiotics,since it may simulate GBS pneumonia.
Diuretics are not useful
Fluid therapy.
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Few needs mechanical ventilation.
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Prognosis
is good, most of the patients recover within 2-5days.
Development of wheezing in early childhood
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