ECHOCARDIOGRAPHIC FINDINGS IN TRANSIENT TACHYPNEA OF THE NEWBORN AND RELATION TO ITS SEVERITY

Abstract

Background: Transient Tachypnea of the Newborn (TNN) is a common self-limited disorder of the
newborn resulting from pulmonary edema due todelayed or inadequate clearance of fetal alveolar
fluid. The initial clinical picture is usually completely resolved by 48 to 72 hours. The aim of the
present study was to assess the cardiac changes in neonates suffering from TTN by Echocardiography.
Patients and methods: A prospective observational study was conducted on 25 neonates suffering
from TTN admitted to the NICU of Zagazig University Obstetrics & Gynecology Teaching Hospital.
This study included 15 males (60%) and 10 females (40%) with a gestational age range from 37-40
weeks and a weight range from 2.69- 4 Kg. All cases were subjected to full history and clinical
examination and detailed maternal history, laboratory and radiological investigations.
Echocardiography was done in all cases as a diagnostic noninvasive tool to assess the cardiac changes
in neonates with TTN.
Results: About 32% of TTN cases associated with pulmonary hypertension 25 % with Mild
PPHT,12.5 % with Moderated PPHT and 62.5% with Sever PPHT None of the cases had impaired LV
functions. Statistically neonates without pulmonary hypertension had higher EF and FS. Among the
studied infants who were delivered vaginally one of two required nasal oxygen and the remaining one
required CPAP. Twelve of the infants who were delivered by elective cesarean section required nasal
oxygen, three required CPAP and two required mechanical ventilation. One infant who were delivered
by emergency cesarean section required mechanical ventilation, five required CPAP. And showed that
oxygen therapy did not vary significantly in relation to mode of delivery. Patients with pulmonary
hypertension on their echo were found to have worse Downes score. They were significantly more
tachycardiac than neonates without pulmonary hypertension. Patients with pulmonary hypertension on
their echo were found to show more acidosis, hypoxia and hypercapnia than those without pulmonary
hypertension.
Conclusion: Our study highlights the value of echocardiography as a non invasive tool in assessing
cardiac changes in neonates suffering TTN and in correlating the presence of cardiac changes to the
severity of the condition.