Respiratory distress syndrome or infant RDS, also known as RDS of the newborn is one of the most common lung disorders in premature infants. It is a life-threatening condition, which is caused by low blood oxygen levels in the air sacs called alveoli of the lungs.

If left untreated, the baby might die within a few days after birth. On the other hand, if an infant is provided with oxygen and kept in a neonatal intensive care unit, he/she can recover completely without any after-effects. Infant respiratory distress syndrome was previously known as hyaline membrane disease.

The RDS affects 10 percent of all preemies and rarely occurs in full term babies.

Risk Factors:

RDS usually affects babies who weigh less than 2.5 kg at birth. Apart from premature delivery, RDS is also seen in some babies whose mothers have diabetes mellitus. Other risk factors are:

• Having a family history of RDS
• Cesarean delivery
• Hypothermia
• Perinatal asphyxia
• Multiple pregnancy (twins or more)
• Male infants reamin at greater risk of RDS

Paradoxically the infant RDS risk will be decreased in situations such as abnormally slow growth of the fetus, high blood pressure in the pregnant women causing a condition caused toxemia and prolonged rupture of the birth membranes, as the stress during these conditions cause the babies lungs to mature much sooner.

Symptoms:

The symptoms of RDS generally appear very soon after the birth, although they may not be seen for several hours. RDS is characterized by shallow/ rapid breathing, unusual breathing movement, grunting noise with each breath, puffy or swollen arms or legs, shortness of breath, nasal flaring, apnea (cessation of breathing), decreased urine output and bluish color of the skin and mucus membranes (cyanosis).

Diagnosis:

The Infant RDS is diagnosed based upon the symptoms present at birth and the known risk factors for the infant such as premature birth or diabetic mother. The test will be done which includes:

Chest X ray – The chest X ray will be done to show whether the baby’s lungs are fully expanded. Little radiations are used in X-rays for babies and do not cause the baby any problems later in life.

Test of the oxygen level in the blood – The blood oxygen level can be checked by either pricking the heel to draw blood or by using an oximeter to earlobes.

The laboratory tests are done to rule out infection and sepsis as a cause of the respiratory distress.

Treatment:

Many babies develop RDS.Babies with the high risk pregnancies and preemies require prompt attention from a neonatal resuscitation team.

A steroid hormone, known as corticosteroid is given by doctors to pregnant women whose baby’s birth cannot be delayed until he or she is full term. Even if the baby develops RDA, the medication will cross the placenta and help the unborn baby’s lungs to produce surfactant, as well as reduce the risk of bleeding in the brain after delivery.

The babies who are born with mild RDS may not need breathing machine. All they need is oxygen hood for a short time to assist with breathing. The doctors may provide oxygen through nasal prongs or a tube placed through the nose to keep the airways open, called as continuous positive airway pressure (CPAP).

But when a baby gets too tired to breathe effectively or say baby born with severe form of RDS will need a ventilator--a device used for forcing air in and out of the lungs through a tube passed through the nose or mouth and into the windpipe-- to give the baby extra breaths.

Many times babies who need a ventilator do need to be treated with a drug that is close to the natural surfacant found in the lungs. They may be given 2 to 4 doses of artificial surfactant, which is dripped into the lungs through a very thin tube in the baby’s trachea. This treatment reduces the risk of lung rupture and within a few days the infant is usually breathing more easily.

Babies with RDS do need round the clock careful fluid management and close monitoring if they develop other situations, such as infections.

If a baby born with the high level of carbon dioxide in the arteries, has low blood oxygen in the arteries or low blood pH level than treatment with the a breathing machine can be lifesaving.

Prevention:

The best method is to delay the premature birth. And if the health care provider knows that the baby is going to be premature, drugs can be given to the mother to help the baby start producing surfactant before birth.

Before getting pregnant the women suffering from diabetes should have control over the disease.

At the time of pregnancy, good prenatal care is essential to a healthy baby and to identify problems as soon as possible.