IMMUNOHISTOCHEMICAL INVESTIGATION OF PULMONARY SURFACTANT IN PERINATAL FATALITIES

In order to verify forensic pathological significance of immunohistoch emical investigation of pulmonary surfactant, 11 forensic and 16 clini co-pathological cases of perinatal death were comparatively examined. Surfactant appeared in some infants of 31-32 weeks gestation and was u sually positive thereafter, indicating maturity of fetal lungs, althou gh it may not have fully developed until about the 36th week of gestat ion. It was negative in all cases of the hyaline membrane disease exce pt for a full-term infant (secondary respiratory distress syndrome). I n usual cases, surfactant coating the expanded alveolar epithelia with its diffuse deposit in the intra-alveolar spaces was considered to in dicate duration of hypoxia under persistent respiration (agonal state) . Such finding was most intensely observed in asphyxia and in severe r espiratory failure from intrinsic causes in the infants over ca. 36 we eks of gestation. With reference to pulmonary micromorphology, the amo unt of intra-alveolar surfactant seemed to be most closely related to the alveolar septal (interstitial) edema.