CYANOSIS IN THE NEWBORN

Cyanosis (<48 hrs) Central Cyanosis ↓ SaO₂ Cyanosis of mouth, tongue, face, core Detailed pregnancy and delivery history Apply oxygen Chest X-ray No improvement in SaO₂ with O₂ → Cardiovascular causes Congenital Heart Disease Transposition of the Great Arteries Truncus Arteriosus Total Anomalous Pulmonary Venous Return Tricuspid Atresia Tetralogy of Fallot Pulmonary Atresia Ebstein’s anomaly Peripheral Cyanosis Normal SaO₂ Cyanosis of hands, feet, perioral Often normal in otherwise healthy newborns (Acrocyanosis) Respiratory Causes Improvement in SaO₂ with O₂ but persistent respiratory distress Upper Airway Congenital upper airway obstruction Airway compression Lower Airway Pneumonia Pneumothorax Meconium aspiration / Meconium pneumonitis Congenital lung anomalies Other Causes Variable response to O₂ Sepsis Hematologic: Anemia Hemoglobinopathies Polycythemia Metabolic disease (e.g., Persistent Pulmonary Hypertension) Disordered control of breathing: Seizure Birth trauma → Intracranial injury Peripartum maternal narcotics * Indicates potentially acutely life-threatening presentations This is not an exhaustive list of medical conditions.