Transient tachypnea of the newborn is temporary rapid and sometimes labored breathing and often low blood oxygen levels due to excessive fluid in the lungs after birth.
This disorder can occur in premature newborns, or in full-term newborns who have certain risk factors.
Affected newborns breathe rapidly and may grunt when breathing out and may appear bluish or gray if they are not getting enough oxygen into their blood.
The diagnosis is based on breathing rate and difficulty and may be confirmed by a chest x-ray.
Some affected newborns need treatment with oxygen, and a few need assistance with breathing.
The characteristic feature of this disorder is that it is temporary (transient), and almost all affected newborns recover completely in 2 to 3 days.
(See also Overview of General Problems in Newborns.)
Tachypnea means rapid breathing. Transient tachypnea means temporary rapid breathing.
Before birth, the air sacs (alveoli) of the lungs are filled with fluid. Immediately after birth, the fluid must be cleared from the lungs so that the air sacs can fill with air and the newborn can breathe normally. Some of the fluid is squeezed out of the lungs by pressure on the newborn's chest during a vaginal delivery, but most of the fluid is rapidly reabsorbed directly by the cells lining the air sacs. Hormones released during labor cause the cells in the air sacs to begin absorbing fluid. If this fluid reabsorption does not occur rapidly, the air sacs continue to be partially filled with fluid and newborns may have difficulty breathing (respiratory distress).
Transient tachypnea of the newborn is more common among premature newborns (delivered before 37 weeks of gestation) and full-term newborns (delivered between 37 weeks and 42 weeks of gestation) who have certain risk factors. For example, in full-term newborns, transient tachypnea is more common among those delivered via a cesarean delivery (C-section). Transient tachypnea is more common among these newborns because the normal labor process does not occur or is shortened. It is also more common among newborns who are large-for-gestational-age, males, infants born earlier (even among those considered full term, born between 37 and 40 weeks of gestation), and among those whose mother had diabetes, asthma, or both during pregnancy.
Symptoms of Transient Tachypnea of Newborn
Newborns with transient tachypnea have trouble breathing almost immediately after birth. The most common symptom is rapid breathing (tachypnea).
Other symptoms include retractions (pulling in of the chest muscles attached to the ribs and below the ribs during rapid breathing), flaring of the nostrils during breathing in, and grunting during breathing out.
Newborns may develop a bluish discoloration of the skin and/or lips (cyanosis) if the level of oxygen in the blood becomes low. In newborns with dark skin, the skin may appear blue, gray, or whitish, and these changes may be more easily seen in the mucous membranes lining the inside of the mouth, nose, and eyelids.
Diagnosis of Transient Tachypnea of Newborn
Breathing rate and difficulty
Chest x-ray
Blood tests and cultures as needed
Doctors suspect transient tachypnea in newborns who have rapid and difficult breathing shortly after birth.
Doctors do a chest x-ray to look for fluid in the lungs and do blood tests and blood cultures to rule out other disorders that cause similar symptoms, such as infection in the blood (sepsis), pneumonia, or respiratory distress syndrome.
Treatment of Transient Tachypnea of Newborn
Oxygen
Sometimes other measures to assist breathing
Newborns sometimes are given oxygen through a 2-pronged tube placed in the nostrils so that they breathe air that contains more oxygen than the air in the room does.
Some newborns may need continuous positive airway pressure (CPAP). CPAP is a technique allows newborns to breathe on their own while being given slightly pressurized oxygen or air given through prongs placed in the nostrils. A few infants occassionally need a ventilator (a machine that helps air get in and out of the lungs).
Prognosis for Transient Tachypnea of Newborn
Most newborns with transient tachypnea recover completely within 2 to 3 days without treatment or with a brief period of added oxygen.
Even with treatment, a very small number of infants develop high blood pressure in the lungs (persistent pulmonary hypertension) or have a collapsed lung (pneumothorax).
