After Birth neonate develops tachypnea, nasal flaring and grunting.Chest X ray was done which shows hazy, ground glass opacities consistent with RDS, baby was born after 33 weeks gestation(preterm infant).RDS occurs due to deficiency of pulmonary surfactant which is primarily composed of lecithin(phosphatidylcholine)secreted by type II pneumocytes. It is commonly seen in preterm infants as surfactant production starts late in gestation.It can be diagnosed early by measuring lecithin:Sphingomyelin ratio in amniotic fluid.It can be prevented by giving Cortisol to the mother within 48 hours before delivery

Differential diagnosis may include:
1)Neonatal Sepsis
2)Transient Tachypnea of newborn
3)Meconium aspiration syndrome
4)Diaphragmatic Hernia
5)Congenital Cardiac Defects

Case submitted by Dr. Bilal Munir MD to radRounds Radiology Network