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Imaging in Transient Tachypnea of the Newborn


Transient tachypnea of the newborn appears soon after birth and has been identified as occurring with cesarean birth and infant sedation.
It may be accompanied by chest retractions, expiratory grunting, or cyanosis, which can be relieved with minimal oxygen. Recovery is usually complete within 3 days.

Radiologically, this syndrome frequently is termed wet lung disease. In the medical literature, discussions concerning transient tachypnea of the newborn can also be found under the following names: retained fetal lung liquid, retention of fetal lung fluid, respiratory distress syndrome type II, transient respiratory distress of the newborn, and neonatal retained fluid syndrome.

The lungs usually are affected diffusely and symmetrically, and the condition is commonly accompanied by a small pleural effusion.
The clinical course of transient tachypnea is relatively benign when compared with the severity suggested by chest films. Radiographic resolution by the second or third day characterizes this entity and differentiates it from other possible disorders; if radiographic resolution is not complete by the third day or if respiratory symptoms persist longer than 5 days, an alternative diagnosis should be sought.

See the images below.

Chest radiograph of a neonate at age 2 days. Moder

Chest radiograph of a neonate at age 2 days. Moderate parenchymal abnormalities with perihilar, streaky markings. No cardiomegaly.

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Radiograph of a neonate at age 4 days. Normal hear

Radiograph of a neonate at age 4 days. Normal heart size and clear lungs are seen.

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Standard chest radiography is the preferred radiologic examination. Initially, it may be difficult to distinguish transient tachypnea from other causes of respiratory distress of the newborn.

The differential diagnosis includes Hyaline Membrane Disease, Meconium Aspiration, and neonatal pneumonia. Other conditions to be considered include respiratory distress syndrome, congenital lymphangiectasia, congenital heart disease, polycythemia, cerebral hyperventilation, and anemia/hypovolemia.

Differentiation from other causes of neonatal respiratory distress may take time. Initial evaluation, monitoring, and basic supportive care must cover all diagnostic contingencies.

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