Transient Tachypnoea of the Newborn

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Transient Tachypnoea of the Newborn (TTN) occurs within hours of birth in 1-2 % of newborn babies. Excess fluid within the airspaces of the lung is either due to incomplete absorption/removal of amniotic fluid from the lungs



Amniotic fluid is partly expelled from the lung through squeezing during passage through the birth canal. Immediately after birth, deep inflation breaths and crying raises the pressure in the lungs and pushes out remaining fluid.

Caesarian Section delivery is a risk factor for TTN. Mild surfactant deficiency was previously thought to be a precipitant.


  • Tachypnoea / signs of respiratory distress shortly after birth, usually following caesarian section delivery.
  • Increased oxygen requirement
  • CXR
    • Prominent pulmonary vasculature / peri-hilar streaking (full lymphatics)
    • Fluid in horizontal fissure / evidence of interstitial fluid
    • Hyperexpanded lung fields
  • Continuous oxygen saturation monitoring
  • Arterial blood gas assessment
    • Consideration of an arterial sampling catheter if the neonate has a high / rising oxygen requirement.
  • Deterioration should prompt consideration of alternative diagnoses

Differential Diagnosis


  • Treatment is largely supportive with neonates recovering over 24-48 hours.
    • Titrate oxygen to saturation monitoring.
    • Observe for tiring / apnoeas.
    • CPAP or rarely mechanical ventilation may be required.
  • Enteral nutrition / IV fluids: usually kept NBM until improving.
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