Neonatal respiratory distress syndrome Quiz: Ace Your Exams

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An infant is delivered at 28 weeks' gestation following premature rupture of membranes with clear amniotic fluid. Only one dose of betamethasone was administered to the parent before delivery. The pregnancy was otherwise uncomplicated. Prenatal labs were negative. The infant is intubated and stabilized in the delivery room before transferring to the Neonatal Intensive Care Unit. Temperature is 36.7°C (98°F), pulse is 148/min, respirations are 32/min, and oxygen saturation is 95% on mechanical ventilation. On physical examination, the eyes are closed, an endotracheal tube is taped in place, and an umbilical vein catheter is in place. Breath sounds are decreased bilaterally, and faint crackles are appreciated throughout the lungs bilaterally. Cardiac examination is normal. Chest radiographs are ordered. Which of the following chest radiographic findings would be consistent with the most likely diagnosis?

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Diffuse ground glass opacities with air bronchograms

Focal infiltrates with air bronchograms

Clear lung fields with decreased pulmonary vascularity

Bilateral perihilar linear streaking

Hyperinflated lungs with flattening of the diaphragms