🔑 Key Learning

  • Most common cause of respiratory distress in the newborn.
  • Caused by delayed clearance of foetal lung fluid.
    • Major risk factor: C-section or very rapid labour (fluid not 'squeezed' out). 
  • Presents with tachypnoea and respiratory distress shortly after birth.
  • Self-limiting, typically resolves within 72 hours.
  • Supportive care with oxygen is usually sufficient.

🧬 Pathophysiology

  • Failure to clear lung fluid at birth results in reduced pulmonary compliance and impaired gas exchange.
  • Especially common after elective caesarean, where hormonal and mechanical triggers for lung fluid clearance are absent.

👀 Clinical Features

  • Onset within the first few hours of life.
  • Tachypnoea > 60 breaths/min
  • Signs of respiratory distress: nasal flaring, grunting, subcostal and intercostal recessions.
  • Self limiting - symptoms typically resolve by 24–72 hours.

⚠️ Risk Factors

  • Caesarean section (especially elective)
  • Prematurity (especially 34–37 weeks)
  • Precipitous (very rapid) labour

🧪 Investigations

  • Chest X-ray may show:
    • Hyperinflated lungs
    • Prominent pulmonary vasculature
    • Fluid in interlobar fissures
    • Possible small pleural effusions

💊 Management

  • Supportive:
    • Oxygen to maintain SpO₂
    • Nasal CPAP in more severe cases
  • Monitoring and reassurance for parents
  • No antibiotics or specific treatment unless infection is suspected

📝 Exam Clues & Clinchers

  • Term baby born by elective caesarean → tachypnoea and grunting within 2 hours → resolves within 3 days.
  • CXR shows fluid in fissures and hyperinflation.