Evaluating the effect of early application of Continuous positive airway pressure (CPAP) via Neopuff in cases of transient tachypnea of the newborn(TTN) and its role in decreasing the duration and complication of TTN.

The aim of the study is to determine whether positive end expiratory pressure therapy (PEEP) administered early via a T piece based infant resuscitator (Neopuff) would safely reduce the incidence of TTN and the need for neonatal intensive care unit (NICU) admission of near term and term infants with respiratory distress.

Inclusion Criteria:

• Near term infants (36-37 weeks gestational age) and Full term infants (38-41 weeks gestational age).
• Presence of signs of respiratory distress (Tachypnea, intercostal and subcostal retractions, nasal flaring and grunting) evident shortly after birth.
• Cesarean section (CS) was defined as elective when surgery was performed before the onset of labor, with all other cases defined as secondary CS.

Exclusion Criteria:

• Presence of any of the risk factors for neonatal sepsis such as Prolonged Rupture of Membranes for ≥48 hours (PROM), maternal fever, maternal chorioamnionitis or positive maternal GBS colonization.

• Presence of any other cause of respiratory distress, eg.

  • congenital malformations affecting the cardiorespiratory system ,
  • chromosomal aberrations,
  • depression at birth (Apgar score at 5 minutes of < 7 or umbilical artery pH of < 7.10),
  • fetal hydrops,
  • persistent pulmonary hypertension,
  • and meconium aspiration syndrome.