INTRAAMNIOTIC INSTILLATION OF SURFACTANT FOR PREVENTION OF NEONATAL RESPIRATORY-DISTRESS SYNDROME (RDS) - A PRELIMINARY-REPORT

Supplementary natural surfactant (SS) was administered intra-amniotica lly (80 mg in 1 ml) under ultrasound guidance in the proximity of the fetal mouth in 5 pregnant women at 28 to 32 wks gestation, with immatu re amniotic fluid indexes of fetal lung maturity, and whose delivery w as imminent because of severe fetal distress as indicated by cardiotoc ography and Doppler velocimetry of maternal and fetal arteries. The ad ministration of SS was preceded by IV aminophylline to the mother (a b olus of 240 mg over 10 min, and a maintenance dose of 0,02-0,1 mg/kg/m in) in order to elicit sustained fetal breathing movements. Following delivery by cesarean section the clinical conditions of four newborn i nfants were good with no respiratory problems, along with an uneventfu l clinical course. However, the newborn infant not exposed in utero to aminophylline showed some respiratory problems which required two ext ra doses of SS after birth. It is suggested that this prophylactic app roach has a great potential for becoming a reliable option for the ant enatal prevention of RDS.