Transient tachypnea of the newborn is respiratory distress caused by delayed resorption of fetal lung fluid.
Transient tachypnea of the newborn affects premature infants, term infants delivered by cesarean section, and infants born with respiratory depression, all of whom have delayed clearance of fetal lung fluid. (Mechanisms for normal resorption of fetal lung fluid are discussed in Perinatal Physiology: Pulmonary function.) For unknown reasons, maternal diabetes and asthma are also risk factors. The disorder can occur in preterm infants with respiratory distress syndrome and in term infants born through meconium-stained amniotic fluid.
Transient tachypnea of the newborn is suspected when the infant develops respiratory distress shortly after birth. Symptoms include tachypnea, intracostal and subcostal retractions, grunting, nasal flaring, and possible cyanosis.
Pneumonia and sepsis may have similar manifestations, so chest x-ray, CBC, and blood cultures usually are done. Chest x-ray shows hyperinflated lungs with streaky perihilar markings, giving the appearance of a shaggy heart border while the periphery of the lungs is clear. Fluid is often seen in the lung fissures. If initial findings are indeterminate or suggest infection, antibiotics (eg, ampicillin, gentamicin) are given while awaiting culture results.
Recovery usually occurs within 2 to 3 days. Treatment is supportive and involves giving O2 by hood and monitoring ABGs or pulse oximetry. Rarely, extremely premature infants, those with neurologic depression at birth, or both require continuous positive airway pressure and occasionally even mechanical ventilation.
Last full review/revision March 2009 by Anand D. Kantak, MD; John T. McBride, MD
Content last modified February 2012