Tachypnea

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Matteo Uschettini - One of the best experts on this subject based on the ideXlab platform.

  • non invasive respiratory support for the management of transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2018
    Co-Authors: Luca Moresco, Matteo Uschettini, Maria Grazia Calevo, Olga Romantsik
    Abstract:

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The objective of this review is to assess benefits and harms of non-invasive respiratory support for themanagement of transient Tachypnea of the newborn.

  • antibiotics for the management of transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2017
    Co-Authors: Luca Moresco, Maria Grazia Calevo, Matteo Uschettini
    Abstract:

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess whether: antibiotics - compared to placebo or no intervention - are effective and safe in the management of infants with a suspected diagnosis of transient Tachypnea of the newborn; it is safe to withhold exposure to antibiotics for infants with a diagnosis of transient Tachypnea of the newborn. We will perform subgroup analyses regarding gestational age; birth weight; mode of delivery; route of administration; type of antibiotic (see Subgroup analysis and investigation of heterogeneity).

  • salbutamol for transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2016
    Co-Authors: Luca Moresco, Matteo Uschettini, Amno Cohe, Alberto Gaiero, Maria Grazia Calevo
    Abstract:

    Background: Transient Tachypnea of the newborn is characterized by Tachypnea and signs of respiratory distress. Transient Tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient Tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of salbutamol (albuterol) for transient Tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. Objectives: To assess whether salbutamol compared to placebo, no treatment or any other drugs administered to treat transient Tachypnea of the newborn, is effective and safe in the treatment of transient Tachypnea of the newborn in infants born at 34 weeks' gestational age or more. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia New Zealand and Pediatric Academic Societies) from 2000 to 2015 and clinical trial registries. Selection criteria: Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing salbutamol versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient Tachypnea of the newborn. Data collection and analysis: For each of the included trials, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation. Main results: Three trials, which included 140 infants, met the inclusion criteria. All three trials compared a nebulized dose of salbutamol with placebo; in one of the three trials newborns were assigned to two different doses of the intervention. We found differences in the duration of oxygen therapy (mean difference (MD) -43.10 hours, 95% confidence interval (CI) -81.60 to -4.60). There were no differences in the need for continuous positive airway pressure (risk ratio (RR) 0.73, 95% CI 0.38 to 1.39; risk difference (RD) -0.15, 95% CI -0.45 to 0.16; 1 study, 46 infants) or the need for mechanical ventilation (RR 1.50, 95% CI 0.06 to 34.79; RD 0.03, 95% CI -0.08 to 0.14; 1 study, 46 infants). Tests for heterogeneity were not applicable for any of the analyses as only one study was included. Among secondary outcomes, we found no differences in terms of duration of hospital stay and Tachypnea. The quality of the evidence was very low due to the imprecision of the estimates. One trial is ongoing. Authors' conclusions: At present there is insufficient evidence to determine the efficacy and safety of salbutamol in the management of transient Tachypnea of the newborn. The quality of evidence was low due to paucity of included trials, small sample sizes and overall poor methodologic quality. (Less)

  • epinephrine for transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2016
    Co-Authors: Luca Moresco, Amno Cohe, Maria Grazia Calevo, Federica Aldi, Matteo Uschettini
    Abstract:

    Background: Transient Tachypnea of the newborn is characterized by Tachypnea and signs of respiratory distress. Transient Tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient Tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of epinephrine (adrenaline) for transient Tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. Objectives: To assess whether epinephrine compared to placebo, no treatment or any other drugs (excluding salbutamol) is effective and safe in the treatment of transient Tachypnea of the newborn in infants born at 34 weeks' gestational age or more. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia and New Zealand and Pediatric Academic Societies) from 2000 to 2015. Selection criteria: Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing epinephrine versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient Tachypnea of the newborn. Data collection and analysis: For the included trial, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy (hours), need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy (hours), need for continuous positive airway pressure and need for mechanical ventilation. Main results: One trial, which included 20 infants, met the inclusion criteria of this review. Study authors administered three doses of nebulized 2.25% racemic epinephrine or placebo. We found no differences between the two group in the duration of supplemental oxygen therapy (mean difference (MD) -6.60, 95% confidence interval (CI) -54.80 to 41.60 hours) and need for mechanical ventilation (risk ratio (RR) 0.67, 95% CI 0.08 to 5.88; risk difference (RD) -0.07, 95% CI -0.46 to 0.32). Among secondary outcomes, we found no differences in terms of initiation of oral feeding. The quality of the evidence was limited due to the imprecision of the estimates. Authors' conclusions: At present there is insufficient evidence to determine the efficacy and safety of epinephrine in the management of transient Tachypnea of the newborn. (Less)

Luca Moresco - One of the best experts on this subject based on the ideXlab platform.

  • non invasive respiratory support for the management of transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2018
    Co-Authors: Luca Moresco, Matteo Uschettini, Maria Grazia Calevo, Olga Romantsik
    Abstract:

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The objective of this review is to assess benefits and harms of non-invasive respiratory support for themanagement of transient Tachypnea of the newborn.

  • antibiotics for the management of transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2017
    Co-Authors: Luca Moresco, Maria Grazia Calevo, Matteo Uschettini
    Abstract:

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess whether: antibiotics - compared to placebo or no intervention - are effective and safe in the management of infants with a suspected diagnosis of transient Tachypnea of the newborn; it is safe to withhold exposure to antibiotics for infants with a diagnosis of transient Tachypnea of the newborn. We will perform subgroup analyses regarding gestational age; birth weight; mode of delivery; route of administration; type of antibiotic (see Subgroup analysis and investigation of heterogeneity).

  • salbutamol for transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2016
    Co-Authors: Luca Moresco, Matteo Uschettini, Amno Cohe, Alberto Gaiero, Maria Grazia Calevo
    Abstract:

    Background: Transient Tachypnea of the newborn is characterized by Tachypnea and signs of respiratory distress. Transient Tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient Tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of salbutamol (albuterol) for transient Tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. Objectives: To assess whether salbutamol compared to placebo, no treatment or any other drugs administered to treat transient Tachypnea of the newborn, is effective and safe in the treatment of transient Tachypnea of the newborn in infants born at 34 weeks' gestational age or more. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia New Zealand and Pediatric Academic Societies) from 2000 to 2015 and clinical trial registries. Selection criteria: Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing salbutamol versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient Tachypnea of the newborn. Data collection and analysis: For each of the included trials, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation. Main results: Three trials, which included 140 infants, met the inclusion criteria. All three trials compared a nebulized dose of salbutamol with placebo; in one of the three trials newborns were assigned to two different doses of the intervention. We found differences in the duration of oxygen therapy (mean difference (MD) -43.10 hours, 95% confidence interval (CI) -81.60 to -4.60). There were no differences in the need for continuous positive airway pressure (risk ratio (RR) 0.73, 95% CI 0.38 to 1.39; risk difference (RD) -0.15, 95% CI -0.45 to 0.16; 1 study, 46 infants) or the need for mechanical ventilation (RR 1.50, 95% CI 0.06 to 34.79; RD 0.03, 95% CI -0.08 to 0.14; 1 study, 46 infants). Tests for heterogeneity were not applicable for any of the analyses as only one study was included. Among secondary outcomes, we found no differences in terms of duration of hospital stay and Tachypnea. The quality of the evidence was very low due to the imprecision of the estimates. One trial is ongoing. Authors' conclusions: At present there is insufficient evidence to determine the efficacy and safety of salbutamol in the management of transient Tachypnea of the newborn. The quality of evidence was low due to paucity of included trials, small sample sizes and overall poor methodologic quality. (Less)

  • epinephrine for transient Tachypnea of the newborn
    Cochrane Database of Systematic Reviews, 2016
    Co-Authors: Luca Moresco, Amno Cohe, Maria Grazia Calevo, Federica Aldi, Matteo Uschettini
    Abstract:

    Background: Transient Tachypnea of the newborn is characterized by Tachypnea and signs of respiratory distress. Transient Tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient Tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of epinephrine (adrenaline) for transient Tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. Objectives: To assess whether epinephrine compared to placebo, no treatment or any other drugs (excluding salbutamol) is effective and safe in the treatment of transient Tachypnea of the newborn in infants born at 34 weeks' gestational age or more. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia and New Zealand and Pediatric Academic Societies) from 2000 to 2015. Selection criteria: Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing epinephrine versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient Tachypnea of the newborn. Data collection and analysis: For the included trial, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy (hours), need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy (hours), need for continuous positive airway pressure and need for mechanical ventilation. Main results: One trial, which included 20 infants, met the inclusion criteria of this review. Study authors administered three doses of nebulized 2.25% racemic epinephrine or placebo. We found no differences between the two group in the duration of supplemental oxygen therapy (mean difference (MD) -6.60, 95% confidence interval (CI) -54.80 to 41.60 hours) and need for mechanical ventilation (risk ratio (RR) 0.67, 95% CI 0.08 to 5.88; risk difference (RD) -0.07, 95% CI -0.46 to 0.32). Among secondary outcomes, we found no differences in terms of initiation of oral feeding. The quality of the evidence was limited due to the imprecision of the estimates. Authors' conclusions: At present there is insufficient evidence to determine the efficacy and safety of epinephrine in the management of transient Tachypnea of the newborn. (Less)

Rita M Rya - One of the best experts on this subject based on the ideXlab platform.

  • recent advances in pathophysiology and management of transient Tachypnea of newborn
    Journal of Perinatology, 2020
    Co-Authors: Ziad Alhasse, Lokesh Guglani, Satya Lakshminrusimha, Payam Vali, Rita M Rya
    Abstract:

    Transient Tachypnea of newborn (TTN) results from failure of the newborn to effectively clear the fetal lung fluid soon after birth. TTN represents the most common etiology of respiratory distress in term gestation newborns and sometimes requires admission to the neonatal intensive care unit. TTN can lead to maternal-infant separation, the need for respiratory support, extended unnecessary exposure to antibiotics and prolonged hospital stays. Recent evidence also suggests that TTN may be associated with wheezing syndromes later in childhood. New imaging modalities such as lung ultrasound can help in the diagnosis of TTN and early management with distending pressure using continuous positive airway pressure may prevent exacerbation of respiratory distress.

  • risk factors and management of transient Tachypnea of the newborn
    Pediatric Health, 2009
    Co-Authors: Lokesh Guglani, Rita M Rya, Satya Lakshminrusimha
    Abstract:

    Transient Tachypnea of the newborn (TTN) is the consequence of delayed clearance of fetal lung liquid in the newborn. With recognition of the increased risk in babies born by Cesarean sections, epidemiologic association with maternal asthma and increasing research on the possible role of genetic polymorphisms of ion-channel subunits, our understanding of the pathophysiology of this condition has vastly improved. We now know that the late-preterm infant, born at 34–36 weeks gestation, is at increased risk for both TTN and respiratory distress syndrome due to surfactant deficiency. As the incidence of Cesarean sections rises, there is likelihood of increased respiratory morbidity in newborns that will necessitate additional medical interventions and exposure to complications of intensive care. This review focuses on the risk factors that are associated with the development of TTN and the treatment strategies that are employed for the management of this condition.

  • transient Tachypnea of the newborn
    Pediatrics in Review, 2008
    Co-Authors: Lokesh Guglani, Satya Lakshminrusimha, Rita M Rya
    Abstract:

    1. Lokesh Guglani, MD* 2. Satyan Lakshminrusimha, MD* 3. Rita M. Ryan, MD* 1. *Department of Pediatrics, University at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, NY The birth of a child is preceded by several changes to prepare for the transition from intrauterine to extrauterine life. The five major events that establish the lungs as the organ of gas exchange at birth include: clearance of fetal lung fluid, establishment of spontaneous breathing, decrease in pulmonary vascular resistance, release of surfactant, and cessation of the right-to-left shunting of venous blood returning to the heart. (1) During fetal life, fluid is secreted into the alveoli to maintain normal growth and function, (2) and fetal lung volume approximates the functional residual capacity that would be established once air breathing is initiated. (3) Clearance of lung fluid can be affected by several factors, and its impairment culminates in Tachypnea and could necessitate transfer to an intensive care unit for monitoring and respiratory support. Transient Tachypnea of the newborn (TTN), which is believed to result from incomplete resorption of fluid from the lungs of the newborn, presents an important diagnostic and therapeutic dilemma in the newborn nursery. This review focuses on TTN, with emphasis on fetal lung fluid mechanics and possible mechanisms of fetal lung fluid resorption as well as its pathophysiology, clinical and diagnostic features, and management. Some neonatologists refer to TTN as retained fetal lung liquid syndrome. The lungs are filled with liquid in utero, which increases from 4 to 6 mL/kg body weight at mid-gestation to about 30 to 50 mL/kg near term in fetal lambs. (4) Jost and Policard (5) first demonstrated that fluid within the fetal lung arises from the lung and contributes to the volume of amniotic fluid. The rate of production ranges from 2 mL/kg per hour in the initial part of pregnancy to 5 mL/kg per hour at term, thereby contributing one third to one half of the daily turnover of amniotic fluid. …

Renato Machado Fiori - One of the best experts on this subject based on the ideXlab platform.

  • surfactant deficiency in full term newborns with transient Tachypnea delivered by elective c section
    Pediatric Pulmonology, 2016
    Co-Authors: Geovana Rhode Estorgato, Humberto Holme Fiori, Manoel A S Ribeiro, Davi De Paula, Pedro Celiny Ramos Garcia, Rita Mattiello, Renato Machado Fiori
    Abstract:

    Introduction Previous studies have suggested that full-term newborns delivered by elective cesarean section who develop transient Tachypnea have low gastric microbubble counts. In the present study, microbubble concentrations in oral fluid samples were used to evaluate pulmonary maturity. Objective To evaluate lung maturity in full-term newborns delivered by elective caesarean section using the stable microbubble test in oral aspirates collected at birth. Method The study involved newborns with gestational age >37 weeks delivered by elective cesarean section. Oral fluid samples were obtained in the delivery room immediately after birth, and gastric fluid was collected within the first hour of life. Samples were frozen and analyzed by two blinded researchers. Results The sample comprised 544 newborns. Twenty-two were diagnosed with transient Tachypnea of the newborn by the assisting physician, and required admission to the Neonatal Intensive or Intermediate Care Unit. The median (interquartile range) of the number of microbubbles in the oral samples of these patients was 67.5 (45–150) microbubbles/mm2. The remaining 498 newborns without respiratory difficulties had a count of 350 (150–750) microbubbles/mm2–P < 0.001. Gastric fluid tests revealed a count of 150 (82.5–700) microbubbles/mm2 for neonates with respiratory difficulties, and of 600 (216–1125) microbubbles/mm2–P < 0.05 for those without respiratory symptoms. Conclusion The present results suggest that transient Tachypnea of the newborn is associated with surfactant dysfunction. Pediatr Pulmonol. 2016;51:596–600. © 2015 Wiley Periodicals, Inc.

  • surfactant deficiency in transient Tachypnea of the newborn
    The Journal of Pediatrics, 2011
    Co-Authors: Humberto Holme Fiori, Pedro Celiny Ramos Garcia, Liane Unchalo Machado, Matteo Aldisserotto, Ana Claudia Vieira, Renato Machado Fiori
    Abstract:

    Objective To evaluate surfactant production and function in term neonates with transient Tachypnea of the newborn (TTN). Study design Samples of gastric aspirates collected within 30 minutes of birth from 42 term newborns with gestational age ≥37 weeks (21 patients with TTN and 21 control subjects), delivered via elective cesarean delivery, were analyzed with lamellar body count and stable microbubble test. Results Results of lamellar body counts and stable microbubble tests were significantly lower in the TTN group than in control subjects ( P = .004 and .013, respectively). Lamellar body counts were significantly lower in infants with TTN requiring oxygen for ≥24 hours after birth than in infants requiring oxygen for P = .029). When the cutoff point was 48 hours, the stable microbubble count was significantly lower in the group requiring oxygen for ≥48 hours than in the group requiring oxygen for P = .047). Conclusions Term infants with TTN had low lamellar body counts associated with decreased surfactant function, suggesting that prolonged disease is associated with surfactant abnormalities.

Satya Lakshminrusimha - One of the best experts on this subject based on the ideXlab platform.

  • recent advances in pathophysiology and management of transient Tachypnea of newborn
    Journal of Perinatology, 2020
    Co-Authors: Ziad Alhasse, Lokesh Guglani, Satya Lakshminrusimha, Payam Vali, Rita M Rya
    Abstract:

    Transient Tachypnea of newborn (TTN) results from failure of the newborn to effectively clear the fetal lung fluid soon after birth. TTN represents the most common etiology of respiratory distress in term gestation newborns and sometimes requires admission to the neonatal intensive care unit. TTN can lead to maternal-infant separation, the need for respiratory support, extended unnecessary exposure to antibiotics and prolonged hospital stays. Recent evidence also suggests that TTN may be associated with wheezing syndromes later in childhood. New imaging modalities such as lung ultrasound can help in the diagnosis of TTN and early management with distending pressure using continuous positive airway pressure may prevent exacerbation of respiratory distress.

  • risk factors and management of transient Tachypnea of the newborn
    Pediatric Health, 2009
    Co-Authors: Lokesh Guglani, Rita M Rya, Satya Lakshminrusimha
    Abstract:

    Transient Tachypnea of the newborn (TTN) is the consequence of delayed clearance of fetal lung liquid in the newborn. With recognition of the increased risk in babies born by Cesarean sections, epidemiologic association with maternal asthma and increasing research on the possible role of genetic polymorphisms of ion-channel subunits, our understanding of the pathophysiology of this condition has vastly improved. We now know that the late-preterm infant, born at 34–36 weeks gestation, is at increased risk for both TTN and respiratory distress syndrome due to surfactant deficiency. As the incidence of Cesarean sections rises, there is likelihood of increased respiratory morbidity in newborns that will necessitate additional medical interventions and exposure to complications of intensive care. This review focuses on the risk factors that are associated with the development of TTN and the treatment strategies that are employed for the management of this condition.

  • transient Tachypnea of the newborn
    Pediatrics in Review, 2008
    Co-Authors: Lokesh Guglani, Satya Lakshminrusimha, Rita M Rya
    Abstract:

    1. Lokesh Guglani, MD* 2. Satyan Lakshminrusimha, MD* 3. Rita M. Ryan, MD* 1. *Department of Pediatrics, University at Buffalo, Women and Children's Hospital of Buffalo, Buffalo, NY The birth of a child is preceded by several changes to prepare for the transition from intrauterine to extrauterine life. The five major events that establish the lungs as the organ of gas exchange at birth include: clearance of fetal lung fluid, establishment of spontaneous breathing, decrease in pulmonary vascular resistance, release of surfactant, and cessation of the right-to-left shunting of venous blood returning to the heart. (1) During fetal life, fluid is secreted into the alveoli to maintain normal growth and function, (2) and fetal lung volume approximates the functional residual capacity that would be established once air breathing is initiated. (3) Clearance of lung fluid can be affected by several factors, and its impairment culminates in Tachypnea and could necessitate transfer to an intensive care unit for monitoring and respiratory support. Transient Tachypnea of the newborn (TTN), which is believed to result from incomplete resorption of fluid from the lungs of the newborn, presents an important diagnostic and therapeutic dilemma in the newborn nursery. This review focuses on TTN, with emphasis on fetal lung fluid mechanics and possible mechanisms of fetal lung fluid resorption as well as its pathophysiology, clinical and diagnostic features, and management. Some neonatologists refer to TTN as retained fetal lung liquid syndrome. The lungs are filled with liquid in utero, which increases from 4 to 6 mL/kg body weight at mid-gestation to about 30 to 50 mL/kg near term in fetal lambs. (4) Jost and Policard (5) first demonstrated that fluid within the fetal lung arises from the lung and contributes to the volume of amniotic fluid. The rate of production ranges from 2 mL/kg per hour in the initial part of pregnancy to 5 mL/kg per hour at term, thereby contributing one third to one half of the daily turnover of amniotic fluid. …