R. Illia, C. Solana, P. Oliveri, J. Toblli, M.U. Imaz, D. Häbich
Evidence of fetal pulmonary aspiration of intra-amniotic administered surfactant in animal experiment
Introduction: The instillation of surfactant into the airways
of patients with respiratory distress syndrome
(RDS), especially in the neonatal period, is a proven therapy.
The preventive therapy of RDS through intra-amniotic
injection of surfactant has been reported recently. It
has not been conclusively shown, however, that the surfactant
administered in this way actually reaches the fetal
pulmonary airways.
Objective: To study the distribution in fetal organs of a
natural surfactant labeled with technetium-99m and
injected through amniocentesis into the amniotic sac of
guinea pigs in the last third of pregnancy.
Methods: After stimulating fetal respiratory movements
with aminophylline 0.3 ml of an aqueous suspension containing
0.75 mg of phospholipids of a natural bovine surfactant
labeled with technetium-99m, together with
0.1 ml of the biological dye carmine indigo, were injected
into the amniotic sac. One hour later fetuses were delivered
by cesarean section. In those that were dye-stained,
dosimetric and gammagraphic tests were applied to trachea,
lungs, esophagus, stomach, heart, liver, kidneys
and placenta.
Results: Significant radio isotopic activity was found in
both lungs of six treated fetuses, with a dose capture of
between 1.0% and 5.3% of total dose. The level of activity
in the stomachs was similar to that in the lungs (0.9%
to 3.0% dose capture), whereas activity in other organs
was negligible except in two placentae. No radio isotopic
activity was found in non-injected control fetuses.
Conclusions: In the present animal model natural surfactant
injected intra-amniotically is aspirated into the
lungs within one hour.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 32, 07/2004
Pages: 354 - 358
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