Transient Tachypnea of the newborn (TTN)
Transient tachypnea of the newborn (TTN) is a respiratory distress occurring in both premature and full-term infants, characterized by rapid as well as labored breathing for a period, due to presence of excess amounts of fluid in the lungs. This temporary respiratory problem causes low levels of oxygen in the blood.
- Rapid breathing with an audible grunt during exhalation is the typical symptom. The skin of the infant may have a bluish tinge due to decreased oxygen levels in the blood.
- Transient tachypnea is very common in premature, as well as full-term infants, delivered by caesarean section before labor has started.
- The typical symptoms help in diagnosis. An x-ray of the chest can confirm the diagnosis.
- Transient tachypnea is a temporary condition, and gets resolved within two or three days, in most cases.
- Supplemental oxygen is given to infants affected by transient tachypnea; some infants may require respiratory support.
Transient tachypnea of newborn (TTN) is a temporary breathing difficulty found to occur in infants who are born a few weeks premature, as well as in those who are born at full term. In fact, TTN is the most common type of respiratory distress found in full-term infants. It occurs more frequently in infants delivered by caesarean section, especially if the delivery has taken place before labor had started in the mother, as in the case of emergency situations, as well as in scheduled caesarean operations.
The alveoli or air sacs of the fetus’ lungs contain fluid before birth. As soon as the baby is born, the lungs should be cleared of the fluid so that the infant can breathe in air normally. During a normal vaginal delivery, as the fetus passes through the birth canal, the pressure exerted on the chest causes most of the fluid in the air sacs of the baby’s the lungs to be squeezed out. The remaining fluid is usually absorbed into the lining of the alveoli.
Certain hormones which are released in the mother during labor cause rapid absorption of the fluid into the lining of the air sacs, leaving the alveoli dry and ready for breathing air, by the time the baby is born. However, when the baby is delivered quickly by a caesarean section, the alveoli continue to have fluid inside, which hampers the normal breathing of the newborn. The breathing difficulty continues till all the fluid gets slowly absorbed and the lungs become dry.
Symptoms and Treatment:
The symptoms of transient tachypnea include respiratory distress characterized by rapid, labored breathing. While the breath is being taken in, the wall of the chest below the breast bone is drawn in, and while breathing out, a grunting sound is heard. Cyanosis or blue coloration of the skin and the extremities may be present if blood levels of oxygen become too low. The presence of fluid in the infant’s lungs can be detected in an x-ray of the chest.
Infants who have transient tachypnea usually begin to breathe normally in two or three days. During the period of respiratory distress, supplemental oxygen is often required. In some cases, oxygen may have to be supplied by the continuous positive airway pressure technique. Oxygen or oxygen-rich air is supplied under slight pressure through nose prongs to make the infant’s breathing easier. Rarely, ventilator support may be necessary in severe cases.
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Yasser Elnahas
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