A Neonate at 38 Weeks Gestation Is Delivered Vaginally Following

A neonate at 38 weeks gestation is delivered vaginally following an uncomplicated pregnancy.  Immediately after delivery, the neonate has respiratory distress.  Examination shows cyanosis, tachypnea, and poor perfusion.  The patient is emergently intubated, and mechanical ventilation is initiated.  A nasogastric tube is also inserted.  On auscultation, asymmetric aeration with decreased left-sided breath sounds are noted.  The abdomen is scaphoid.  A chest x-ray is shown in the exhibit. 
Which of the following is the most likely cause of this patient's respiratory distress?

A) Dilated airspaces with bronchiolar metaplasia
B) Increased pulmonary capillary wedge pressure
C) Loss of negative intrapleural pressure
D) Pulmonary surfactant deficiency
E) Underdevelopment of pulmonary tissue

Correct Answer:

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