A term male neonate born by elective cesarean section at 38 weeks without any labour develops tachypnoea of 85 breaths per minute within 2 hours of birth. He has mild subcostal retractions and needs FiO2 0.28 to maintain saturation. By 36 hours he is breathing comfortably in room air. Chest X-ray taken earlier showed prominent perihilar vascular markings with fluid in the minor fissure. What is the MOST likely diagnosis?
- A Respiratory distress syndrome due to surfactant deficiency
- B Neonatal pneumonia acquired in utero
- C Transient tachypnoea of the newborn ✓
- D Meconium aspiration syndrome
Correct answer: C. Transient tachypnoea of the newborn
Explanation
Transient tachypnoea of the newborn results from delayed clearance of fetal lung fluid, classically after cesarean delivery without labour, since the catecholamine surge and thoracic squeeze of vaginal delivery are absent. It peaks within hours, needs minimal supplemental oxygen, and resolves by 24 to 72 hours. Radiographs show perihilar streaking and fluid in the fissures. Surfactant deficiency occurs in preterm infants with ground glass appearance, while pneumonia and aspiration produce a persistent course rather than spontaneous resolution.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.