Differential diagnosis of respiratory distress

Although nurse-midwives care for essentially normal women, even healthy pregnant women at term may deliver babies with respiratory distress. Nurse-midwives need the knowledge to decide whether an infant with respiratory distress needs immediate evaluation by a pediatrician or neonatal specialist or can be safely observed for a while to see if the respiratory distress resolves. This paper reviews the developmental anatomy and physiology of the respiratory system and the pathophysiology of the most common causes of immediate respiratory distress in the newborn. This information will aid nurse-midwives in making appropriate differential diagnoses and management plans for the newborns in their care.