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Next we're going to discuss neonatal lung disorders

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of term and post-term babies.

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Whereas in the last couple

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of sections we were discussing neonatal lung disorders

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of preterm babies.

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These entities occur typically in term or post-term babies.

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The first case I'll show you here,

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the images actually flipped when you pull it up in your

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viewer, so you can use your tools

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to flip it horizontally so it looks like this.

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So the patient's cardiac apex is on their left side.

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This is a baby that was born at 39 weeks gestation

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by cesarean section.

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You can see that there are perihilar patchy

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and streaky opacities, as well

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as bilateral pleural effusions.

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This baby turned out to have transient tikia of the newborn,

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which occurs not uncommonly in babies born by C-section

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because they did not undergo that, the thoracic squeeze

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of vaginal delivery.

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Hence, they have a little bit

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of leftover fluid in their lungs that will clear on its own.

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Notice this baby does not require an endotracheal tube

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because usually they're not in respiratory distress

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and they will clear out this fluid on their own.

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Also, notice subtly this baby has

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small ossification centers in their shoulders,

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and we can expect to see those in term

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or post-term babies, whereas they're not usually present in

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preterm babies yet.

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And that's a quick and dirty way

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that you can eyeball whether a baby is a preterm

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or a term slash post-term baby.

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This same patient had a follow-up radiograph a few hours

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later with no intervention,

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and you can see that those opacities have

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substantially improved on both sides.

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We still have a very tiny pleural effusion on the right

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and maybe a hint of one on the left,

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but overall, their picture is improving.

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This next case is also of a term baby

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born at 40 weeks gestational age.

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However, this patient has a different appearance.

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Right off the bat, you can see

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that they have an endotracheal tube, which tells us

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that they're having respiratory difficulty,

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which we don't expect

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with transient to kidney of the newborn.

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Like in the last case here we can see a number of findings.

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We see multifocal coarse rope like opacities,

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particularly extending from the central hilar regions.

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We can see rural effusion on the right

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and also a subtle pneumothorax.

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On the left, we see atelectasis superimposed

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in the right upper lobe.

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And all of these are findings consistent

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with meconium aspiration syndrome.

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Meconium aspiration syndrome is a complication

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that it can occur in term

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or particularly post-term babies if there is meconium,

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stained amniotic fluid at delivery.

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And then when they aspirate, they can develop this lung

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Disease.

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They can have any of these features that we see here.

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Again, we see these rope like opacities, pleural effusion,

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pneumothorax, and often hyper expansion.

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In this next case, this is another baby

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that was born at 40 weeks old, also

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with meconium aspiration syndrome, also

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with the pleural effusion.

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On the right side here again, we see multifocal opacities,

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many of which have a rope like appearance.

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We see additional,

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more confluent atelectasis in the retro cardiac region

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as well as in the right upper lobe.

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And this is just another appearance of the same entity.

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And finally, we have another patient also

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with meconium aspiration syndrome.

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Just to give you another appearance,

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this baby was born at 40 weeks gestational age.

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They also subsequently developed e coli sepsis.

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Notice that those rope like opacities throughout the lungs,

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the pleural effusion on the right side

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and additionally atelectasis in the upper lobe.

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So this is yet another case

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with meconium aspiration syndrome.

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Just to give you a sense of the different appearances

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that have many similar features

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and something to think about in a term or post-term baby.