Requirements of perinatal prevention and treatment of respiratory distress syndrome

In the last decade the strategy for the prevention of the neonatal respiratory distress syndrome (RDS) has been directed towards the acceleration of foetal lung maturation in utero by means of drugs administrated to the mother, the most thoroughly investigated being glucocorticoids. Harmful potential side effects of glucocorticoids have led to testing of other drugs capable of accelerating foetal lung maturation, including ambroxol and aminophylline. More recently supplementary surfactant instilled into the trachea has been shown to improve oxygenation of premature babies and to reduce the severity of RDS. To minimise the incidence of neonatal RDS it is important to identify pregnant women at risk for preterm labour and to establish specific guidelines for the use of any prenatal drug to be administered for prevention of RDS. It is also mandatory to assess foetal lung maturity in case of preterm delivery, to monitor the foetus intensively intrapartum, to prevent birth asphyxia and to control, and promptly correct derangements of neonatal homeostasis.