Cosmi E V, La Torre R, Piazze J J, Maranghi G L, Lerro N, Bianco D, Anceschi M M
2nd Department of Obstetrics and Gynecology, University La Sapienza, Policlinico Umberto I, Rome, Italy.
Eur J Obstet Gynecol Reprod Biol. 1997 Feb;71(2):135-9. doi: 10.1016/s0301-2115(96)02623-1.
To evaluate the efficacy of intramniotic instillation of supplementary surfactant for the prophylaxis of neonatal IRDS in an emergency obstetric setting.
Supplementary natural surfactant (SS) was administered intra-amniotically (80 mg in 1 ml) under ultrasound guidance in the proximity of the fetal nostrils and mouth in six pregnant women at 24-32 weeks gestation, with immature amniotic fluid indices of fetal lung maturity, and whose delivery was imminent because of severe fetal distress, deteriorating maternal conditions, or refractory vaginal bleeding. The administration of SS was preceded by IV aminophylline to the mother (a bolus of 240 mg over 10 min, and a maintenance dose of 0.02-0.1 mg kg-1 min-1) in order to elicit sustained fetal breathing movements.
The clinical conditions of the six newborn infants were good with no respiratory problems in four cases, and with mild IRDS in the remaining two, which, however, resolved uneventfully.
It is suggested that this prophylactic approach has a great potential for becoming a reliable option for the antenatal prevention of IRDS.
评估在紧急产科情况下羊膜腔内注入补充表面活性剂预防新生儿呼吸窘迫综合征（IRDS）的疗效。
对6例妊娠24 - 32周、羊水胎儿肺成熟指标不成熟、因严重胎儿窘迫、母体情况恶化或难治性阴道出血而即将分娩的孕妇，在超声引导下于胎儿鼻孔和嘴附近羊膜腔内注入补充天然表面活性剂（SS，1毫升含80毫克）。在注入SS之前，先给母亲静脉注射氨茶碱（10分钟内推注240毫克，维持剂量为0.02 - 0.1毫克/千克/分钟），以引发胎儿持续呼吸运动。
6例新生儿临床状况良好，4例无呼吸问题，其余2例有轻度IRDS，但均顺利康复。
提示这种预防方法很有可能成为产前预防IRDS的可靠选择。
