[Fetal outcome of premature infants less than 1,500 g birth weight with special reference to surfactant requirements].
The objective of our study was to examine therapeutic success within a study group of 108 premature babies weighing less than 1500 g at birth. The foetal outcome was divided according to intrauterine betamethasone administration, method of birth and surfactant requirement. 59 of the babies did not require a surfactant factor, because within 12 hours it was possible, to reduce respiration to an O2 partial pressure of 20%. In 49 of the premature babies, this was not possible, and therefore, surfactant substitution was required, whereby this subject group was divided into surfactant responders and surfactant non-responders. In addition, we examined the influence of the method of birth on later survival and the occurrence of intraventricular haemorrhages in the children. A noticeably higher survival rate was determined in 81% of the children, born via Caesarean section, compared with 63% of premature babies, born via vaginal delivery. Likewise, detectable intraventricular haemorrhages (IVH) were significantly lower amongst premature babies delivered via Caesarean section (25%) than those delivered vaginally (37.5%). A considerable improvement in survival rates and a reduction in IVH was achieved by means of completed lung maturation with betamethasone (16 mg in 48 hours). 62% of premature infants with completed prepartal lung maturity did not require the administration of a surfactant due to the favourable respiratory situation. However, for those cases, where it was no longer possible to conduct lung maturation, only 46% did not require surfactant substitution. Therefore, it would appear advisable, to delay the delivery of premature babies weighing less than 1500 g in order to carry out lung maturity treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Strittmatter
H J
HJ
Frauenklinik des Klinikums Mannheim, Fakultät für klinische Medizin, Universität Heidelberg.
Wischnik
A
A
Lasch
P
P
Friese
K
K
Melchert
F
F
Kachel
W
W
D000206:Actuarial Analysis; D002585:Cesarean Section; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight / Q000502:physiology*; D007231:Infant, Newborn; D010102:Oxygen Inhalation Therapy; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality* / Q000628:therapy; D012307:Risk Factors; D015996:Survival Rate