Transient tachycardia of the newborn

Question 1

What is transient tachypnoea of newborn?

Answer 1

Retained foetal fluid/wet lung disease
First few hours of life, retaining fluid on lungs causing tachypanoea, reolves in 48 hours

Question 2

Risk factors for TTN

Answer 2

C section delivery
Maternal diabetes
Maternal asthma

Question 3

Clinical presentation TTN

Answer 3

Respiratory distress
Classically with grunting and nasal flaring in first 6 hours of life
Mild cyanosis sometimes

Question 4

How is amnitoic fluid normally expelled from lungs after birth

Answer 4

Amniotic fluid normally expressed during vaginal delivery and absorbed after birth and prostaglandins dilate pulmonary lymphatics to absorb excess fluid

Question 5

What causes reduced fluid absorpiton off of lungs in TTN

Answer 5

Reduced mechanical squeeze
Reduced capillary and lymphatic removal of amniotic flujd

Question 6

When is prostaglandin imbalance more likely at brith?

Answer 6

Maternal diabtetes or asthma
Male newborns

Question 7

Features of TTN on plain radiograph

Answer 7

Interstitial oedema - perihilar streakiness
Pleural effusions usually small
Mild to moderate cardiomegaly (rare)
Severe cases perihilar alveolar opacities
SHOULD BE NORAML 48-72 hours POSTPARTUM

Question 8

US for TTN

Answer 8

Double lung point sign
Rule out consolidated lung (air bronchogrma)

Question 9

Differential diagnosis TTN

Answer 9

CHD
Neonatal penumonia
Aspiration - meconium
Persistent foetal ciculation
Respiratory distress syndrome

Question 10

Rep distree syndrome vs TTN how differentiate

Answer 10

Lung volumes slightly decreased in RDS - normal to slightly hyperinflated in TTN