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Overview of neonatal respiratory distress: Disorders of transition

Richard Martin, MD
Section Editor
Joseph A Garcia-Prats, MD
Deputy Editor
Melanie S Kim, MD


Respiratory distress is common immediately after birth, and is typically caused by abnormal respiratory function during the transition from fetal to neonatal life. It is manifested by tachypnea, nasal flaring, intercostal or subcostal retractions, audible grunting, and cyanosis. Neonatal respiratory distress may be transient; however, persistent distress requires a rational diagnostic and therapeutic approach to optimize outcome and minimize morbidity.

This topic review provides an overview of the pathogenesis, clinical features, and approach to initial management of three common respiratory disorders of perinatal transition: transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and persistent pulmonary hypertension of the newborn (PPHN). These disorders, including their specific management, are discussed in greater detail separately. (See "Pathophysiology, clinical manifestations, and diagnosis of respiratory distress syndrome in the newborn" and "Persistent pulmonary hypertension of the newborn" and "Transient tachypnea of the newborn".)


The successful transition from fetal to neonatal life at delivery requires a series of rapid physiologic changes of the cardiorespiratory system. These changes result in redirection of gas exchange from the placenta to the lung, and comprise:

Replacement of alveolar fluid with air [1]

Onset of regular breathing

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Literature review current through: Nov 2017. | This topic last updated: Jun 06, 2016.
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