Retained fetal lung fluid

Alternative Names

Definition

Transient tachypnea is a respiratory disorder usually seen shortly after delivery in babies who are born near or at term. Transient means it is short-lived (usually less than 24 hours) and tachypnea means rapid breathing (most normal newborns take 40-60 breaths per minute).

Causes

During fetal life the lungs make a special fluid that fills the lungs and helps them to grow. At term, chemicals released during labor tell the lungs to stop making this special fluid and to start removing or reabsorbing it. The first few breaths your baby takes after delivery fill the lungs with air and help to clear most of the remaining lung fluid. Passage through the birth canal may also help clear some fluid by squeezing the chest.

If your baby was born prior to term (less than 38 weeks) he may not respond as well to the chemical signals released during labor leaving more fluid in the lung at birth.

If you had a cesarean section (C-section) without being in labor, the chemical signals telling the lung to stop making and start removing lung fluid are not as strong, again leaving more fluid in the lung at the time of birth. If you have diabetes

Symptoms

Newborns with TTN have respiratory problems soon after birth (within 1-2 hours). These "problems" usually consist of some combination of rapid, noisy breathing (grunting), and/or the use of extra muscles to breathe (flaring nostrils, or movements between the ribs or breastbone known as "retractions").

Exams and Tests

The mother's pregnancy and labor history are important to make the diagnosis. A chest x-ray may be taken to eliminate other causes of respiratory problems. A blood count (CBC) and blood culture may be drawn to try to rule out infection.

TTN is usually diagnosed after monitoring your baby for 1-2 days.

Treatment

Your baby will be given oxygen as needed to maintain an adequate blood oxygen level. Pulse oximeter and/or blood gases may be used. Your baby's oxygen requirement will usually be highest within a few hours after birth and then begin to decrease. Most infants with TTN improve in less than 12-24 hours.

If your baby is breathing very rapidly, feedings may be withheld and IV fluids given for nutrition until your baby improves. Your baby may also receive antibiotics during this time until infection is ruled out. Rarely, babies with TTN may have persistent lung problems for as long as 1 week.

Outlook (Prognosis)

TTN usually resolves completely within 24 hours after delivery. Babies who have had TTN usually have no further problems from it and require no special care or follow-up other than their routine pediatrician visits.