خديج وُلد في الأسبوع ٢٩ بولادة سريعة، ولم تأخذ أمه كورتيزون. بعد الولادة بقليل صار عنده تنفس سريع ٧٦، وتراجع الصدر، وأنين مع الزفير، والتشبع ٨٤٪. الأشعة تظهر رئتين بمظهر زجاجي حبيبي. ما السبب الأرجح وعلاجه الأساسي؟

A baby born precipitously at 29 weeks without antenatal steroids develops, shortly after birth, RR 76, chest recession, expiratory grunting and SpO2 84%. X-ray shows a ground-glass granular appearance. What is the likely cause and its main treatment?

1. Surfactant deficiency, treated with surfactant and CPAP
2. Mild dehydration after birth, treated with IV fluids
3. Early infant asthma, treated with inhaled salbutamol
4. Bacterial pneumonia, treated with an oral antibiotic

Answer: A) Surfactant deficiency, treated with surfactant and CPAP. Respiratory distress syndrome of prematurity results from surfactant deficiency, so alveoli collapse. Treatment is CPAP and endotracheal surfactant; antenatal steroids to the mother reduce its incidence.