A term neonate born by emergency cesarean section for fetal distress presents with tachypnea, mild cyanosis, and a CXR showing fluid in the horizontal fissure and perihilar streaking. Oxygen saturation improves rapidly with 40% oxygen. Which is TRUE about this condition?
- A It is caused by surfactant deficiency and requires exogenous surfactant therapy
- B Retained lung fluid fails to clear because thoracic squeeze is absent; resolves within 24–72 hours ✓
- C It is caused by persistent pulmonary hypertension and requires sildenafil as first-line therapy
- D CXR typically shows hyperinflation with flattened diaphragms and air trapping
Correct answer: B. Retained lung fluid fails to clear because thoracic squeeze is absent; resolves within 24–72 hours
Explanation
Transient tachypnea of the newborn (TTN) results from delayed clearance of fetal lung fluid, particularly in cesarean births where the thoracic squeeze of vaginal delivery is absent. Fluid in the horizontal fissure and perihilar streaking are hallmark radiological findings. It resolves spontaneously within 24–72 hours with supportive oxygen. Surfactant deficiency causes RDS; PPHN is a separate entity with more severe hypoxemia; hyperinflation with air trapping suggests meconium aspiration syndrome.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.