Spontaneous Pneumothorax in the Newborn

Spontaneous pneumothorax can occur in the newborn infant and if not recognized may have fatal consequences. It should be suspected in any infant in respiratory distress. It may be caused by over-enthusiastic attempts at resuscitation with pressure breathing apparatus, but more often it occurs spontaneously. In the latter instance it is probably due to occlusion of some of the smaller air passages by aspirated meconium. The patient with a small pneumothorax and only moderate distress may recover completely with no treatment other than observation in an oxygen-enriched atmosphere. If considerable distress persists, continuous drainage of the pneumothorax should be provided by means of an intercostal drain and an underwater seal.