The estimation of perinatal pulmonarymaturity: A commentary

Abstract

TI-IE MOST COMMON fatal pulmonary disorder of the neonatal infant is the idiopathic respiratory distress syndrome (RDS) or hyaline membrane disease. It is primarily a disease of premature infants, especially those born before the completion of 37 weeks' gestation. Approximately 500 infants die of this disease each week in the United States? Most afflicted infants have respiratory difficulty and acidosis while still in the delivery roomY, 8 The respiratory rate is variable and usually rapid in the early stages. As the disease progresses, grunting and retractions develop; rales uncommon. Muscular tone is poor, and the abdomen may become distented because of air swallowing. Hypoxemia becomes progressively more severe despite oxygen administration. The chest roentgenogram shows a characteristic ground-glass , reticular-granular pattern with prominant bronchial structures? Recovery occurs, often dramatically, between 48 and 72 hours in those infants who survive to that time. Deaths after 72, hours of life are likely to be associated with complications such as secondary infection or pulmonary or intracranial hemorrhage. At autopsy, lungs from infantg' dying of hyaline membrane disease are atelectatic and sink if placed in saline solution. Avery and