నైరూప్య

Clinical and lung ultrasonographic features of transient tachypnea of newborn in a tertiary care hospital in Bangalore

Shruthi Patel*, Chandrakala P

Introduction: Transient tachypnea of the newborn (TTN) also called wet lung, occurs due to delayed clearance of lung fluid. The diagnosis of TTN was primarily based on medical history, clinical manifestations, arterial blood gas analysis, and chest radiography (CXR). It is estimated that over 70% of infants with TTN are clinically misdiagnosed with Respiratory distress syndrome (RDS). Lung ultrasound (LUS) is an emerging technique that could be used for early detection of TTN. This study aims to evaluate the value of lung ultrasound in the diagnosis of TTN in late-preterm and full-term neonates.

Material and Methods: Sixty five late preterm and term neonates with signs of respiratory distress were included in this prospective observational study from January 2016 to June 2017. Lung ultrasound was done within the first 24 hours of birth and assessed according to the observation indices like A-line, B-line and Double lung point.

Results: On lung ultrasound, 53 (81.5%) neonates showed the feature of double lung point (DLP) while 41 (63.1%) neonates showed A-line. The respiratory symptoms subsided in 38 (58.4%) babies at room air while only 2 (3.1%) babies required continuous positive airway pressure ventilation. The DLP feature on LUS was significantly more in babies born to primi mothers than multigravida (p value 0.02) and those delivered through LSCS when compared to babies delivered vaginally (p value- 0.01).

Conclusion: TTN is a self-limiting condition and treatment is mainly supportive. The results of this study further demonstrate that LUS can accurately and reliably diagnose TTN. Therefore, significantly reducing the need for chest X-rays and ultimately result in lower exposure of a neonate to ionizing radiation. This will aid in counselling the parents regarding its benign nature and conservative management.