[Preventive treatment of respiratory distress syndrome in newborn infants with antepartal glucocorticoid administration (betamethasone). Clinical results and changes in the lecithin/sphingomyelin ratio of the amniotic fluid]

Abstract

Betamethason was administered to 105 patients with threatened premature labour at risk for respiratory distress syndrome (RDS) of the newborn. The most important indications were premature rupture of the membranes (30%) and premature labour (40%). The betamethason treatment was given between the 27. and 35. week of gestation. 79% of the patients delivered prior to 36 weeks of gestation, over 50% prior to 34 weeks gestation. The total incidence of RDS was 25%. Severe types of RDS (stage III and IV) were rare (7%). The mortality of RDS after betamethason treatment was 5.4%. After 32 weeks gestation the mortality from RDS was 0%. Severe types of RDS appear to occur more often in male than in female infants. The incidence of RDS was not lowered further by premature of the membranes. The lecithin/sphingomyelin(L/S)-ratio in the amniotic fluid following treatment with betamethason increased to over 2 in only 2/3 of the cases. The predictive value of the L/S ratio that respiratory distress syndrome of the newborn only occurs rarely with values over 2 was maintained after treatment with betamethason. Our rate in cases with an L/S ratio over 2 was 7.9%.