Neonatal respiratory distress... Health Article

Complications

Air or gas may build up in:

• The space surrounding the lungs (pneumothorax)
• The space in the chest between two lungs (pneumomediastinum)
• The area between the heart and the thin sac that surrounds the heart (pneumopericardium)

Other complications may include:

• Bleeding into the brain (intraventricular hemorrhage of the newborn)
• Bleeding into the lung (sometimes associated with surfactant use)
• Blood clots due to an umbilical arterial catheter
• Bronchopulmonary dysplasia
• Delayed mental development and mental retardation associated with brain damage or bleeding
• Retinopathy of prematurity and blindness

Calling your health care provider

This disorder usually develops shortly after birth while the baby is still in the hospital. If you have given birth at home or outside a medical center, seek emergency attention if your baby develops any difficulty breathing.

Prevention

Preventing prematurity is the most important way to prevent neonatal RDS. Ideally, this effort begins with the first prenatal visit, which should be scheduled as soon as a mother discovers that she is pregnant. Good prenatal care results in larger, healthier babies and fewer premature births.

Avoiding unnecessary or poorly timed cesarean sections can also reduce the risk of RDS.

If a mother does go into labor early, a lab test will be done to determine the maturity of the infant's lungs. When possible, labor is usually halted until the test shows that the baby's lungs have matured. This decreases the chances of developing RDS.

In some cases, medicines called corticosteroids may be given to help speed up lung maturity in the developing baby. They are often given to pregnant women between 24 and 34 weeks of pregnancy who seem likely to delivery in the next week. The therapy can reduce the rate and severity of RDS, as well as the rate of other complications of prematurity, such as intraventricular hemorrhage, patent ductus arteriosus, and necrotizing enterocolitis. It is not clear if additional doses of corticosteroids are safe or effective.

References

Cloherty J, Stark A, Eichenwald E. Manual of Neonatal Care. 5th ed. Lippincott, Wilkins and Williams; 2003.

Cole FS. Defects in surfactant synthesis: clinical implications. Pediatr Clin North Am. Oct 2006; 53(5): 911-27.

Courtney SE. Continuous positive airway pressure and noninvasive ventilation. Clin Perinatol. Mar 2007; 34(1): 73-92.

Kinsella JP, Inhaled nitric oxide in the premature newborn. J Pediatr. Jul 2007; 151(1): 10-5.

Lampland AL. The role of high-frequency ventilation in neonates: evidence-based recommendations. Clin Perinatol. Mar 2007; 34(1): 129-44.

Stevens TP. Surfactant replacement therapy. Chest. May 2007; 131(5): 1577-82.