Respiratory distress syndrome of the newborn

What it is

Respiratory distress syndrome (RDS) is the respiratory problem of pre term birth. It is also called hyaline membrane disease, and the histology is a proteinaceous exudate.

It comes from a deficiency of pulmonary surfactant. Surfactant lowers surface tension, so where it is deficient the surface tension increases, and the result is widespread alveolar collapse and inadequate gas exchange.

The more preterm the infant, the higher the incidence of RDS; it is common in infants born before 28 weeks' gestation.

Causes and risk

The risks named are preterm infants, infants of a DM mother, low birth weight, multiple gestation and male.

Pre term itself means after 20 weeks and before 37 weeks of gestation, and RDS heads the respiratory problems that follow pre term birth, alongside pneumothorax and apnoea and bradycardia. The rest of that list is worth holding with it: need for resuscitation at birth; hypotension; patent ductus arteriosus; temperature control; the metabolic group of hypoglycaemia, hypocalcaemia, electrolyte imbalance and osteopenia of prematurity; nutrition; infection; jaundice; periventricular leukomalacia; necrotising enterocolitis; retinopathy of prematurity; anaemia of prematurity; iatrogenic problems; bronchopulmonary dysplasia, which is chronic lung disease; and inguinal hernias.