Match each clinical and radiographic presentation in a newborn with the most likely underlying neonatal respiratory disorder.
- A 39-week gestation infant born via elective cesarean delivery develops tachypnea. Chest radiograph reveals prominent perihilar streaking and fluid in the interlobar fissures.Transient tachypnea of the newborn
- A 29-week gestation infant develops severe retractions and grunting shortly after birth. Chest radiograph shows a diffuse reticulogranular ground-glass appearance with air bronchograms.Respiratory distress syndrome
- A 41-week gestation infant born after fetal distress develops tachypnea and cyanosis. Chest radiograph demonstrates coarse, patchy infiltrates with alternating areas of atelectasis and hyperinflation.Meconium aspiration syndrome
- A 40-week gestation infant presents with profound hypoxemia out of proportion to clear lung fields on the chest radiograph. Echocardiography demonstrates right-to-left shunting across the patent ductus arteriosus.Persistent pulmonary hypertension of the newborn
Answer
The presentations map to Transient tachypnea of the newborn (retained fluid), Respiratory distress syndrome (surfactant deficiency), Meconium aspiration syndrome (meconium aspiration), and Persistent pulmonary hypertension of the newborn (pulmonary hypertension), respectively.
Each respiratory disorder has a classic triad of gestational age risk, pathophysiology, and radiographic appearance. Identifying the correct pair relies on recognizing delayed fluid clearance (Transient tachypnea of the newborn), surfactant deficiency (Respiratory distress syndrome), aspirated obstructive debris (Meconium aspiration syndrome), and elevated pulmonary vascular resistance (Persistent pulmonary hypertension of the newborn).
Step-by-Step Solution
Key Concept
Differentiation of neonatal respiratory distress requires integrating gestational age, delivery history, and characteristic radiographic findings.