Neonatal Pneumonia

[Montessori Mommy]

I'm an L & D nurse in a community hospital, with a question about a delivery this weekend....

A baby is born to a mom who had a URI when she went into labor. After persistant decels, mom is sectioned. (Needless to say, anthesia isn't happy, but the baby had to get out ASAP!) Baby was suctioned & received O2, but was doing great after a few minutes.

A few hours after c-section, mom is getting worse, and it's determined she has pneumonia. She has minimal contact with baby because she is just too sick.

24 hours later, baby starts exhibiting symptoms, gets chest xray, and is sent to NICU at regional medical center.

My question: Where did the baby get pneumonia? Before birth, apsiration just after delivery or from mom after delivery? It seems unlikely the baby would get it before birth since mom wasn't septic.... It seems like it would have taken more than 24 hours for baby to get that sick if he was first exposed to mom's pneumonia after delivery. I asked the OB today what he thought, but he wasn't sure either.

Thanks!

[prmenrs, RN]

Babies delivered by C-section often get pneumonia b/o not clearing fluid from their lungs (retained fetal lung fluid that doesn't clear ---> pneumonia). It's not really related to mom's illness.

[dawngloves, BSN, RN]

Doesn't sound like pneumonia. Sounds like TTN. Xrays are often similar.

[Montessori Mommy]

Babies delivered by C-section often get pneumonia b/o not clearing fluid from their lungs (retained fetal lung fluid that doesn't clear ---> pneumonia). It's not really related to mom's illness.

That was my first thought, too! I'm not sure why the OB dismissed that when I mentioned it.

[Montessori Mommy]

Doesn't sound like pneumonia. Sounds like TTN. Xrays are often similar.

Another RN mentioned this, too, and the OB said it would have presented itself before 24 hours..... I'm off to do some research so I can bring it in tomorrow. Once I start asking 'why?', I get obsessed and can't stop until I find an answer!!

[Jolie, BSN]

It is possible that mother's illness was viral and was tansmitted via the placenta prior to delivery.

One of the sickest babies I've ever cared for was a little girl who was scheduled to be delivered by section. Mom presented to her OB's office a few days prior to the scheduled date with a bad URI, and it was decided to section her that day, based on the ?logic? that she would recover faster from her illness in a non-pregnant state. Unfortunately, baby was born with an apparent respiratory infection. (She got mom's virus, but didn't stay in utero long enough to get mom's antibodies?) She was horrifically sick, spent a loonngg time on a vent, and went home months later with chronic lung disease and O2 requirements.

[elizabells, BSN, RN]

I feel like I've seen GBS pneumonia too... is it an amniotic fluid with GBS in the fetal lungs process?

[preemieRNkate, RN]

Elizabells mentioned GBS, what was mom's GBS status? GBS can do some nasty things to babies, including pneumonia. The other thought I had initially is the baby developed pneumonia because of the c-section. I don't think that the baby's illness is really related to mom's. Have you gotten any update on the baby?