[Prevention of hyaline membrane disease]

Prevention of respiratory distress syndrome (RDS) may be achieved with measures aimed at lung maturation and at prevention of perinatal asphyxia. Besides successful inhibition of premature labor, the following substances have clinical importance in lung maturation: glucocorticosteroids, thyroid hormones, aminophylline and ambroxol. The efficacy of prenatal steroids has been demonstrated in numerous studies. Most of the potential risks in this treatment have not shown any relevance in clinical trials. Prenatal steroids are so far the standard approach to lung maturation. Certain contraindications and limitations need to be taken into consideration. The results with thyroid hormones are still limited and also contradictory. When steroids are contraindicated, they may still be of possible value. Aminophylline was found to be just as efficacious as steroids, with fewer infectious complications. These studies are, however, limited in number. Ambroxol was found to improve lung maturation after the 32nd week of gestation in a few studies. It seems to have few side effects. Possibly, it will also prove to be effective in treating established RDS.