Transient tachypneic of

newborn

Dr Asraf Amirullah
 Transient Tachypneic of Newborn

Definition

Transient: intermittent, temporary

Tachypneic: RR > 60 bpm

Also known as wet lungs.

Transient Tachypneic of
Newborn

Pathophysiology

Caused by leftover fluid in the lungs.

Before birth, baby’s lung are filled with fluid
to help them grow and develop.

Higher incidence in foetus affected by LSCS,

shorten second stage, premature baby and
especially in elective cases also in
macrosomic baby
Transient Tachypneic of Newborn
Pathophysiology
 Transient Tachypneic of Newborn
Symptoms includes
• Rapid breathing

• Nasal flaring

• Cyanosis

• Chest recession
 Transient Tachypneic of Newborn
Investigations
FBC
- to look for increase in TWC
Chest Xray
- for fluid in lungs shown as bilateral diffuse symmetrical hazy airspace
- Hyperiflated (normal lung shown until 6 ribs anteriorly and 8 ribs posteriorly)

-Fluids in the fissures

-Hazziness

ABG
- look for signs of type 1 or type 2 respiratory failure. Commonly type 1 as pt is hypoxic.
 Transient Tachypneic of Newborn
Treatment

- Oxygen supplementation: bubbling

- CPAP
Congenital Pneumonia

Dr Asraf Amirullah
 Congenital Pneumonia
Definition:

Also well known as “intrauterine pneumonia”

An inflammatory pulmonary process that originate from the lung or be a focal complication of a
contiguous or systematic inflammatory process

Usually will occur within 24hours

 Congenital Pneumonia

Risk factors

- Unexplained preterm labor

- PROM (prolonged leaking)
- Hx of maternal fever (>38’C)
- Foul smelling or changing colour of amniotic fluid
- Previous history of infant with GBS or any infections (Especially invasive GBS)
- Meconium stained liquour
- Recurrent maternal urinary tract infection
- GBS infection in current pregnancy
 Congenital Pneumonia
Most common bacteria in neonates

-Group B streptococcus , E coli , Klebsiella ,Enterococcus bacteria

Route of infections

-hematogenous (Mother with bacterimia)

-ascending (Birth canal infections -important to ask any PV discharge)

-aspiration ( Aspiration of infected AF )

3 categories
True congenital pneumonia
Intrapartum pneumonia
Postnatal pneumonial
 1. True congenitalpneumonia

- establish at birth

2. Intrapartum pneumonia

-during birth due to contact with the infections of birth canal

3. Postnatal pneumonia

Occur within 24H after delivery

Common symptoms
Tachypnea,cyanosis,chest indrawing,fever,lethargy,refuse for feedings
 On examinations

Active / Lethargic
Pink / Cyanose
Irritable
Signs of respiratory distress (Nasal flaring,chest recession,grunting)
Dull upon percussion of lung field
On ausculatation equal / reduce breathes sound sometimes associate with crepitations or wheezes
Unable to saturate under room air and requiring oxygen supplements
Investigations
FBC to look for infections
ABG to look for types of respiratory failure
Blood C&S to determine presence of bacterimia
CXR
CXR

• Opacity showing consolidation

• Hyperinflated lungs
• Perihilar effusion
 Treatment
Main aim is to eradicate the infections and to provide adequate oxygen support to the baby

Oxygen supplementation (Nasal cannula,Cpap,Bipap)

Antibiotic

-IV Ampicilin 50mg/kg/dose 12hourly

-IV Cefutaxime50mg/kg/dose 12hourly

-Syrup Eythromycin 50mg/kg/dose 8hourly

-IV Gentamycin 4Mg/kg/dose 24hourly