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Delayed Transition from Fetal Circulation

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Delayed Transition from Fetal Circulation

  • See Also
  1. Transient Tachypnea of the Newborn
  2. Birth Transition from Fetal Circulation
  3. Respiratory Distress in the Newborn
  • Pathophysiology
  1. Retained alveolar fluid with incompletely expanded alveoli (typically due to precipitous Vaginal Delivery)
  2. Diagnosis of exclusion as a cause for Newborn Respiratory Distress
  3. Made in hindsight after no obvious other sources identified
    1. Tachypnea readily resolves within minutes to hours
  • Findings
  1. Respiratory Rate 60 to 80 breaths/min
  2. Mild increased work of breathing
  3. Improves rapidly after first 4 hours (contrast with TTN which typically lasts up to 48 hours)
  • Differential Diagnosis
  1. See Respiratory Distress in the Newborn
  2. See Neonatal Distress Causes
  3. Transient Tachypnea of the Newborn (TTN)
    1. Respiratory Rate often >80 breaths/min
    2. Increased work of breathing
    3. Improves over 24-48 hours
  • Management
  1. Always consider the differential diagnosis
    1. Delayed transition (and TTN) are diagnoses of exclusion
  2. Supportive care
  3. Resolves spontaneously
  • References
  1. Buel (2026) Am Fam Physician 113(1): 35-41 [PubMed]
  2. Hermansen (2015) Am Fam Physician 92(11): 994-1002 [PubMed]