| RDS |
- Preterm (<34 weeks) — key risk factor
- Surfactant deficiency → ↑ surface tension → alveolar collapse
- Ground-glass opacities + air bronchograms on CXR
- Low lung volumes on CXR
- Exogenous surfactant + CPAP or mechanical ventilation
- Prevented by antenatal corticosteroids (betamethasone)
- Worsens over first 4–6 hours, then stabilizes
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| TTN |
- Term or near-term infant
- Born via cesarean section (no thoracic squeeze to expel fluid)
- Delayed resorption of fetal lung fluid → ↓ compliance → mild hypoxia
- Perihilar streaking + fluid in fissures on CXR
- Self-resolves within 12–24 hours
- Supplemental O2 only; no surfactant needed
|
| Meconium Aspiration |
- Post-term or term infant with meconium-stained amniotic fluid
- Aspiration of thick meconium → ball-valve obstruction + chemical pneumonitis
- Hyperinflation + patchy infiltrates on CXR
- Persistent pulmonary hypertension (PPHN) complication
- Suction at delivery + surfactant lavage + inhaled NO if PPHN develops
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| Neonatal Pneumonia |
- Risk factors: maternal fever, prolonged ROM (>18h), GBS colonization
- Early-onset sepsis: within first 72 hours of life
- Patchy infiltrates ± pleural effusion on CXR
- Group B Streptococcus (GBS) most common organism
- Empiric ampicillin + gentamicin
- Maternal GBS screening + intrapartum antibiotic prophylaxis prevents
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