Acute Respiratory Distress Syndrome in a Full-Term Newborn: Report of One Case

Respiratory distress syndrome, previously called hyaline membrane disease, is a common cause of morbidity and mortality associated with premature delivery. The incidence and severity of respiratory distress syndrome generally increase with decreasing gestational age at birth, and its occurrence in the at-term baby is rare. We report a male newborn who was born via elective cesarean section at 38 4/7 weeks gestation. After birth, he subsequently had severe respiratory distress typical of surfactant deficiency severe enough to be managed with ventilator support. He showed no evidence of intrapartum infection or aspiration. After two doses of surfactant were instilled via endotracheal tube, his respiratory condition showed dramatic improvement and recovered fully without complication before discharge. We report this case to emphasize the possibility that a term baby may develop surfactant-deficient respiratory failure and to suggest that elective delivery before 39 weeks gestation should be undertaken only for good medical reasons. In addition, the pathogenesis of acute respiratory distress syndrome in full-term neonates is discussed.