A preterm newborn develops respiratory distress shortly after birth. What are the possible differential diagnoses, and how would you approach initial management?
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Great question. Think of systems first: Causes can be respiratory, cardiac, metabolic, CNS/ neurological and then miscellaneous.
This will lead us to differentials. Obviously, think of common causes first: respiratory causes are the most common in this clinical vignette.
#neonatology #premie #pediatrics
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D/d
Respiratory Distress syndrome due to surfactant deficiency.
Transient Tachypnea of Newborn.
Congenital anomalies.
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Who else can answer it better than sir!!
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In a preterm newborn with respiratory distress, the main differentials diagnosis includes:
• Respiratory Distress Syndrome (RDS) – surfactant deficiency
• Pneumonia/Sepsis – perinatal infection
• Transient Tachypnea of the Newborn (TTN) – delayed lung fluid clearance
• Pneumothorax – air leak
• Congenital anomalies – e.g., diaphragmatic hernia
Initial management:
• Stabilize airway and breathing – warm environment, oxygen, CPAP/ventilation
• Supportive care – fluids, thermoregulation
• Investigations – CXR, blood tests, ABG
• Start empirical antibiotics if infection is suspected
• Give surfactant if RDS is likely
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