[Recent acquisitions in hyaline membrane disease]

Hyaline membrane disease is an important factor in the postnatal mortality of prematures. Its pathogenesis is examined. Prematurity, maternal diabetes, and caesarean section are seen as predisposing causes. Delayed biochemical maturation of the lung (shown by a low lecithin-sphyngomyelin ration in the amniotic fluid and probably caused by hypophyseal-adrenal insufficiency) results in an absence of surfactant. Labour stimulates its production by massive release of endogenous cortisol. The part played by betamethasone and other substances in prophylaxis is discussed. It is felt that, at present, the availability of preformed tensioactive factors alone can achieve the decidedly improved prognosis required in so serious a disease.