Prevention of respiratory distress syndrome: synergistic therapies.

Postnatal surfactant therapy, antenatal glucocorticoid therapy and now antenatal combined hormone therapy with glucocorticoids and TRH all appear to be effective in reducing the incidence of RDS or in ameliorating the severity of this condition. There is also evidence from animal and human studies that a combination of hormone therapy and surfactant therapy is more effective than either therapy alone. If the current trials of combined hormone therapy for the prevention of RDS continue to produce encouraging results, it is likely that in the near future threatened premature delivery before 33 weeks will be treated with tocolytics and a combination of glucocorticoid and TRH therapy. This is likely to be followed with prevention or rescue surfactant therapy. These new approaches should have a major impact in reducing the mortality and morbidity associated with premature birth.