A term male neonate born by elective cesarean section at 38 weeks develops tachypnea of 90 breaths per minute at 1 hour of life with mild retractions and an oxygen requirement of 28%. He is otherwise active with normal perfusion. Chest X-ray shows prominent pulmonary vascular markings, fluid in the minor fissure, and a small pleural effusion. By 48 hours he is breathing comfortably in room air. What is the most likely diagnosis?
- A Transient tachypnea of the newborn ✓
- B Respiratory distress syndrome
- C Neonatal pneumonia
- D Meconium aspiration syndrome
Correct answer: A. Transient tachypnea of the newborn
Explanation
Delayed clearance of fetal lung fluid causes transient tachypnea of the newborn, classically after cesarean delivery without labour, since the catecholamine surge and thoracic squeeze of vaginal delivery are bypassed. The radiograph shows perihilar streaking, fluid in the fissures and small effusions, and the course is benign with resolution within 24 to 72 hours. RDS occurs in preterm infants with ground glass appearance, and pneumonia does not resolve this rapidly.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.