Sumaira was born at 32 weeks by emergency caesarean section for fetal stress. The family was a new immigrant, and from the medical history, antenatal ultrasound showed polyhydramnios with an amniotic fluid index up to 50, which is twice the upper limit of normal. Intervention by amnioreduction therapy has been performed twice before the delivery. A fetal detail scan performed at 21 weeks of gestation did not detect any underlying cause for the polyhydramnios. Sumaira’s birth weight was 2 kg, and the Apgar score was 6 at 1 min and 9 at 5 min. Sumaira developed repeated desaturation despite being put on nasal oxygen; hence, she was admitted to the intensive care unit and managed with continuous positive airway pressure support (CPAP). A CXR and an AXR were taken. The reported history of polyhydramnios raises concerns. What underlying conditions could explain Sumaira’s respiratory distress?