Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomized Controlled Trial of Fluid Management in Transient Tachypnea of the Newborn
Brief Summary: Transient tachypnea of the newborn (TTN) is a diagnosis given to infants born between 34 and 42 weeks gestation who develop difficulty breathing during the first days of life when no specific cause of the breathing difficulty can be identified. Little is known about why some babies develop TTN, and there have not been many formal studies of the best way to take care of babies with this disease. Babies with TTN get better on their own within three to five days after birth, but may require extra oxygen to breath well.

Most physicians believe that the symptoms of TTN are related to poor clearance of fluid from the newborn's lungs. Babies with TTN have extra fluid visible on chest x-ray. Diuretics, medicines that can help clear extra lung fluid in adults and in babies with extra lung fluid for other reasons, do not to help babies with TTN. Babies with TTN need intravenous fluids to be healthy because they breathe too fast to be able to eat. Breastfed babies only get a very small amount of fluid in the first few days of life, as it normally takes several days for a new mother to begin producing breastmilk. No one has yet examined whether giving babies with TTN an amount of fluid similar to the small amount they would receive if they could breastfeed would help them recover from TTN faster.

In this study, the investigators compare whether giving newborns "standard" intravenous fluid or amounts of intravenous fluid more close to what a breastfed baby would receive speeds recovery in newborns with TTN.


Options:
A: Inclusion Criteria:

1. Gestational age at birth 34 and 42 weeks of gestation
2. Admission to the Mount Sinai NICU during the first 24 hours of life
3. Diagnosis during the first 24 hours of life of transient tachypnea of the newborn

Exclusion criteria:

1. Gestational age at birth less than 34 weeks or greater than 42 weeks at birth
2. No diagnosis of TTN made in the first 24 hours of life
3. Additional infant diagnosis of major cardiac disease
4. Additional infant diagnosis of major pulmonary disease other than TTN
5. Additional infant diagnosis of meconium aspiration syndrome
6. Additional infant diagnosis of major congenital anomaly with potential to affect respiratory status in the neonatal period
7. Additional infant diagnosis of infectious disease process potentially affecting respiratory status in the neonatal period
8. Observation of thick meconium in the amniotic fluid at delivery.
9. Maternal diagnosis of chorioamnionitis or other infection of the uterus or fallopian tubes pre- or peri-partum.

Criteria for removal from the study:

(a) Additional infant diagnosis of major cardiac, pulmonary, or other disease process potentially affecting respiratory status in the neonatal period (i.e., infection, meconium aspiration, pneumothorax, congenital anomaly) present during the study period. (b) Positive test of infection (e.g. blood, CSF, or urine culture; viral DFA; microscopy) drawn from infant at any point during the study period. (c) Maternal diagnosis of chorioamnionitis or other infection of the uterus or fallopian tubes at any point during hospital stay. (d) Objective clinical signs of dehydration: (i) Newborn urine output less than 2 mL/kg/hr over a twelve hour period at any point during the study period. (ii) Newborn serum sodium less than 130 mEq/L or greater than 150 mEq/L at any point during the study period. (iii) Newborn weight loss \>10% of birth weight at any point during the study period.

(e) Newborn blood glucose by point-of-care testing of less than 40 mg/dL at any point during the study period. (f) Administration of exogenous surfactant at any point during the study period.
B: Inclusion Criteria:

* Late preterm and term infants (post-menstrual age ≥ 34 weeks) delivered by cesarean section or vaginal delivery
* Diagnosis of TTN
* Parents signed informed consent

Exclusion Criteria:

* Meconium aspiration syndrome
* Respiratory distress syndrome
* Congenital heart disease
* Non respiratory disorders causing tachypnea
C: Inclusion Criteria:

* Caesarean newborn
* Gestational age ≥ 35 weeks
* Weight ≥ 2 kg
* SaO2 \< 90% after 10 min of life
* Silverman score ≥ 5
* Treated less than 20 min after birth
* Social security affiliation (parents)
* Informed consent signed (parents)

Exclusion Criteria:

* Thoracic retraction
* Congenital intrathoracic malformations
* Meconium aspiration
* Early neonatal infections with hemodynamic troubles
* Severe neonatal asphyxia
* Polymalformative syndrome
D: 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.

Answer: A