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  • Title: [Analysis of selected methods for intrauterine stimulation of fetal pulmonary maturation].
    Author: Sledziewski A, Kinalski M, Kretowski A.
    Journal: Przegl Lek; 2000; 57(3):171-7. PubMed ID: 10909290.
    Abstract:
    Preterm delivery is still a major cause of infant morbidity and mortality. Premature infants develop numerous complications including respiratory distress syndrome, intraventricular hemorrhage, patent ductus arteriosus, necrotising enterocolitis, etc. Respiratory distress syndrome is the leading problem in perinatology. The incidence of RDS accounts for 70% of all infants delivered before 30 week's gestation and about 20% neonates born between 32-37 week of pregnancy. Our paper presents current opinions and is a critical review of relevant literature on antenatal treatment before anticipated preterm deliveries. Recently performed meta-analysis prove that glucocorticoid therapy is effective in reducing aforementioned pathologies of prematurity. After brief account on effects of several hormones on fetal pulmonary maturity some beneficial interactions for enhanced fetal maturity are pointed out. Glucocorticoid mechanism of action in target cells and its biochemical implications are reviewed. The use of antenatal corticoids for fetal maturation and possible adverse maternal effects follow. Finally both short-term and long-term benefits of ANS are discussed. Thus there are convincing data to support the use of ANS in fetal pulmonary maturation. The current findings suggest that the improvement of respiratory outcome may depend on enhanced expression of phospholipids and proteins of the surfactant system and enzymes of antioxidant systems. We believe that use of antenatal corticosteroids for fetal maturation results in improvement of neonatal outcome and yields substantial savings in health care costs.
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