Zhang Jian-ping, Wang Ying-lan, Wang Yun-hui, Zhang Rui, Chen Huan, Su Hao-bin
Department of Gynecology and Obstetrics, Second Hospital of Zhongshan University, Guangzhou 510120, China.
Chin Med J (Engl). 2004 Jan;117(1):120-4.
Neonatal respiratory distress syndrome (NRDS) is caused by a deficiency in pulmonary surfactant (PS) and is one of the main reasons of neonatal mortality. This study was conducted to evaluate the efficacy and safety of intra-amniotic administration of pulmonary surfactant for prophylaxis of NRDS.
Forty-five pregnant women who were due for preterm delivery and whose fetuses' lungs proved immature were divided into two groups. Fifteen women (study group) were administered one dose of pulmonary surfactant injected into the amniotic cavity and delivered within several hours. Nothing was injected into the amniotic cavity of 30 women of the control group. The proportion of neonatal asphyxia, NRDS, mortality and the time in hospital were analyzed to determine if there was any difference between the two groups.
There was no significant difference between the two groups for neonatal asphyxia. Foam tests showed that higher proportion of neonates in the study group than in the control group (56.3% vs 13.3%, P < 0.05) had lung maturity. A greater number of control neonates (11/30, 32.3%) had NRDS, compared with the neonates given PS via the amniotic cavity before delivery (1/16, 6.3%, P < 0.05). The neonates in the study group spent nearly 10 days less in hospital than the control group [(32.4 +/- 7.6) days vs (42.0 +/- 15.7) days, P < 0.05], but the difference in mortality between the two groups was not statistically significant.
Intra-amniotic administration of pulmonary surfactant can significantly reduce the proportion of NRDS and the time in hospital of preterm neonates. Whether this method can reduce the mortality of preterm neonates needs to be evaluated further. Intra-amniotic administration of pulmonary surfactant provides an additional effectual means for NRDS prophylaxis.
新生儿呼吸窘迫综合征（NRDS）由肺表面活性物质（PS）缺乏引起，是新生儿死亡的主要原因之一。本研究旨在评估羊膜腔内注入肺表面活性物质预防NRDS的有效性和安全性。
45例因早产且胎儿肺不成熟的孕妇被分为两组。15例孕妇（研究组）羊膜腔内注入一剂肺表面活性物质，并在数小时内分娩。对照组30例孕妇的羊膜腔内未注入任何物质。分析新生儿窒息、NRDS、死亡率及住院时间的比例，以确定两组之间是否存在差异。
两组新生儿窒息情况无显著差异。泡沫试验显示，研究组中肺成熟的新生儿比例高于对照组（56.3%对13.3%，P<0.05）。与分娩前经羊膜腔给予PS的新生儿相比，对照组有更多新生儿发生NRDS（11/30，32.3%对1/16，6.3%，P<0.05）。研究组新生儿住院时间比对照组少近10天[（32.4±7.6）天对（42.0±15.7）天，P<0.05]，但两组死亡率差异无统计学意义。
羊膜腔内注入肺表面活性物质可显著降低早产儿NRDS的比例及住院时间。该方法能否降低早产儿死亡率有待进一步评估。羊膜腔内注入肺表面活性物质为预防NRDS提供了一种额外的有效手段。
