Transient tachypnea of the newborn

Transient Tachypnea of the Newborn

Transient tachypnea of the newborn (TTN) is a respiratory condition that affects newborns, characterized by rapid breathing during the first few hours of life. It is a common cause of respiratory distress in term and late preterm infants.

Pathophysiology

Transient tachypnea of the newborn occurs due to delayed clearance of fetal lung fluid. During fetal life, the lungs are filled with fluid, which is normally absorbed shortly before or during birth. In TTN, this fluid clearance is delayed, leading to accumulation of fluid in the lungs and resulting in respiratory distress.

The condition is more common in infants delivered by Cesarean section without labor, as the hormonal and physical changes associated with labor help in the clearance of lung fluid. Other risk factors include maternal diabetes, macrosomia, and male gender.

Clinical Presentation

Newborns with TTN typically present with:

• Tachypnea (rapid breathing) with a respiratory rate greater than 60 breaths per minute.
• Mild retractions and nasal flaring.
• Grunting.
• Cyanosis may be present but is usually mild.

Symptoms usually appear within the first two hours after birth and typically resolve within 24 to 72 hours.

Diagnosis

The diagnosis of TTN is primarily clinical, supported by the history and physical examination. However, a chest X-ray is often performed to rule out other causes of respiratory distress. The X-ray may show:

• Prominent pulmonary vascular markings.
• Fluid in the interlobar fissures.
• Mild cardiomegaly.

Management

Management of TTN is supportive. The mainstay of treatment includes:

• Providing supplemental oxygen to maintain adequate oxygen saturation.
• Monitoring vital signs and respiratory status.
• Ensuring adequate thermoregulation and nutrition.

Most infants with TTN improve with supportive care and do not require mechanical ventilation.

Prognosis

The prognosis for infants with TTN is excellent. The condition is self-limiting and typically resolves within a few days without long-term complications.

Also see

• Respiratory distress syndrome
• Meconium aspiration syndrome
• Neonatal pneumonia
• Persistent pulmonary hypertension of the newborn