Respiratory distress syndrome: progress in prenatal prediction and prevention.

The concept of idiopathic respiratory distress syndrome (RDS) as a disease of multiple etiology has shifted during the past decade to that of a developmental biochemical dysfunctional state which has a distinct pattern of clinical expression. Knowledge of the biosynthetic processes of physiologic lung maturation together with the now available perinatal technology have made possible laboratory analysis and quantification of surface active phospholipids, and also correlation of their concentrations with the subsequent respiratory status. Whereas prediction of the syndrome now appears well established, such is not the case with prevention although significant breakthroughs have undoubtedly occurred. It is hoped that development of simple and safe modalities of preventive intervention will follow soon in the wake of these pioneering major accomplishments.