A diabetic female at 40 wks of gestation delivered a baby by elective cesarean section. Soon after birth, the baby developed respiratory distress. The diagnosis is –
Correct Answer: Transient tachypnea of the new bom
Description: Ans. is 'a' Transient tachypnea of the newborn (Ref. Nelson, 16th/e, p. 505; Ghai O.P., 5th/e, p. 145).lam going against the majority in this question. Most of the students believe that the answer is a Hyaline membrane.Now read carefully what Nelson has to say about HMD." Hyaline membrane disease occurs primarily in premature infants, the incidence is inversely proportional to the gestational age and birth weight. It occurs in 60-80% of infants less than 28 wks of gestational age, in 15-30% of those between 32 and 36 wks in about 5% beyond 37 wk and rarely at term*".So it must be clear to you that hyaline membrane disease is rare in a term infant and the infant in question is a term infant (40 wks).About transient tachy apnea, It's written that "it usually follows uneventful normal preterm or term vaginal delivery or Cesarian delivery. "SOHyaline membrane disease is an important cause of respiratory distress in preterm infants and rarely in term infants whereas transient tachy apnea of the newborn causes respiratory distress in term infants.Now the only confusion left us about diabetes (it increases the incidence of hyaline membrane disease in infants.1 thinks the history of diabetes is given to confuse us.Remember that prematurity is the most important factor for HMD.Well, It's just my way of interpretation of the facts, I may be wrong on this one.
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