A diabetic female at 39 weeks of gestation delivered a baby by elective cesarean section. Soon after bih the baby developed respiratory distress. Chest X-ray shows opacity in right middle lobe fissure. The diagnosis is:
The differential diagnosis for the newborn with tachypnea in the first postnatal hours ranges from RDS to sepsis to CHD. The most common causes of tachypnea in the newborn is transient tachypnea of the newborn (TTN). TTN results when fetal lung fluid production fails to cease with the onset of labor. The incidence of TTN is significantly increased when the baby is delivered caesarean section without labor especially if performed before 39 weeks of gestation. The newborn presents with tachypnea, increased work of breathing, and cyanosis. CXR reveals interstitial and alveolar edema; fluid is characteristically seen in the right middle lobe fissure. Symptoms of TTN typically resolve over the first 24-48 hours (fetal lung fluid production ceases in response to stress), and CXR clears by the second or third day of life. Ref: Raab E.L., Kelly L.K. (2013). Chapter 22. Neonatal Resuscitation. In A.H. DeCherney, L. Nathan, N. Laufer, A.S. Roman (Eds), CURRENT Diagnosis & Treatment: Obstetrics & Gynecology, 11e.
Transient tachypnea of the newborn
Congenital diaphragmatic hemia
Tracheo oesophageal fistula
Hyaline membrane disease