Fetal lung maturation: the combined use of corticosteroids and thyrotropin-releasing hormone.
The purpose of this randomized study was to evaluate whether the combined use of corticosteroids and thyrotropin-releasing hormone would enhance fetal lung maturation to a greater degree than would corticosteroids alone. The study was restricted to patients under 34 weeks' gestation with a lecithin/sphingomyelin (L/S) ratio less than 2.0. The patients were randomized into a study group receiving intravenous thyrotropin-releasing hormone along with intramuscular corticosteroids over 48 hours and a control group receiving only corticosteroids. Patients undelivered 1 week after the onset of therapy underwent a repeat amniocentesis to document changes in the L/S ratio. In those patients delivering within 1 week of therapy, the neonatal clinical course was established by two investigators blinded to the antenatal therapy. Compared with the control group, the group receiving antenatal corticosteroids plus thyrotropin-releasing hormone showed a greater post-therapy increase in L/S ratio, fewer respirator days, and a lower incidence of bronchopulmonary dysplasia. The results of this study suggest that the combined use of corticosteroids and thyrotropin-releasing hormone results in enhanced fetal pulmonic maturation superior to that achieved with corticosteroids alone.
Morales
W J
WJ
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
O'Brien
W F
WF
Angel
J L
JL
Knuppel
R A
RA
Sawai
S
S
D001623:Betamethasone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005325:Fetal Organ Maturity; D006801:Humans; D007231:Infant, Newborn; D008168:Lung / Q000196:embryology*; D011247:Pregnancy; D011897:Random Allocation; D012127:Respiratory Distress Syndrome, Newborn / Q000517:prevention & control*; D013973:Thyrotropin-Releasing Hormone / Q000627:therapeutic use*
D013973:Thyrotropin-Releasing Hormone; D001623:Betamethasone