The effect of pulmonary surfactant on prevention of neonatal respiratory distress syndrome in neonates delivered via caesarean section

Abstract

Objective To study the pulmonary surfactant (PS) on prevention of neonatal respiratory distress syndrome (NRDS) in neonates delivered via caesarean section. Methods From selective cesarean section infants (gestational age 34 - 38+6 W), 80 cases whose test tube oscillation tests were negative and amniotic fluid pulmonary surfactant associated protein A (SP- A) concentrations were lower than <10 μg/L, and were randomly divided into PS prevention group and control group, with 40 cases in each group. PS prevention group within 1 h of birth were administrated poractant alfa injection by endotracheal tube (dose 100 mg/kg), but the control group was not given special treatment, leaving only the observation. The incidence of NRDS, treatment status and clinical progression were compared between two groups. Results The incidence of NRDS in control group was 82.5% (33/40), in PS prevention group was 37.5%(15/40), and there was significant difference (P <0.05). The degree of NRDS in control group was more severe. The incidence rate of persistent pulmonary hypertension of the new-born (PPHN), pulmonary air leak, patent ductus arteriosus and oxygenation index above 25 mmHg (1 mmHg = 0.133 kPa) in control group were significantly higher than those in PS prevention group (P <0.05). The time of mechanical ventilation, the time of oxygen inhalation, ratio of arterial partial pressure of oxygen (PaO2) before mechanical ventilation to fraction of inspired oxygen (FiO2), and costs of hospitalization in control group were significantly higher than those in PS prevention group (P <0.05). Conclusions PS prevention can reduce the incidence of NRDS of neonates delivered by elective caesarean section, can alleviate the symptoms of NRDS, shorten length of stay and reduce the cost of hospitalization. Key words: Cesarean section; Respiratory distress syndrome, newborn; Pulmonary surfactant