Respiratory distress syndrome refers to breathing difficulty experienced by many premature babies, due to underdevelopment of their lungs. The earlier a baby is born the more likely he is to suffer from RDS. Babies born at 28 weeks have a 70% chance of developing RDS. This figure drops to around 10% for babies born at 34 weeks gestation.
Cause
Because the lungs of premature babies are immature they do not produce a substance called surfactant, which lines the lung surface and prevents collapse of the smallest airways (alveoli) used for oxygen exchange. This substance starts being produced when the baby is around 28 weeks gestation.
Clinical features
A baby suffering from RDS will have difficulty breathing, having to work very hard with each breath. His chest may be drawn in and he will grunt when he tries to breathe out.
Investigations
Diagnosis of RDS is usually confirmed by chest X-ray.
Treatment
Babies with RDS require highly specialised treatment in a special care nursery. They will be nursed in a humidicrib and will require oxygen administered through a special hood. Sometimes they will require oxygen through a tube passed into their windpipe, and some babies may be hooked up to a special breathing machine (ventilator) for days or even weeks. Artificial surfactant is also now available, and this helps those babies with respiratory distress due to immature lungs.
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