Lung responses to ultrasound-guided fetal treatments with corticosteroids in preterm lambs

Jobe, A. H., Polk, D., Ikegami, M., Newnham, J., Sly, P., Kohen, R. and Kelly, R. (1993) Lung responses to ultrasound-guided fetal treatments with corticosteroids in preterm lambs. Journal of Applied Physiology, 75 5: 2099-2105.

Author Jobe, A. H.
Polk, D.
Ikegami, M.
Newnham, J.
Sly, P.
Kohen, R.
Kelly, R.
Title Lung responses to ultrasound-guided fetal treatments with corticosteroids in preterm lambs
Journal name Journal of Applied Physiology   Check publisher's open access policy
ISSN 8750-7587
Publication date 1993-11
Sub-type Article (original research)
Volume 75
Issue 5
Start page 2099
End page 2105
Total pages 7
Place of publication Bethesda, MD, United States
Publisher American Physiological Society
Language eng
Formatted abstract
Maternal corticosteroid treatments augment lung function in the human preterm infant. However, not all fetuses respond, the response requires ≥48 h of exposure, and multiple maternal doses expose the mother to potential risks. To evaluate the potential of direct fetal therapy, we used ultrasound to direct fetal intramuscular or intravascular injections of corticosteroids or saline in sheep and subsequently delivered the preterm lambs at 128 days gestational age to assess postnatal lung function. Relative to saline- injected controls, 0.5 or 2 mg/kg betamethasone given as a single intramuscular dose 48 h before delivery increased compliance and the efficiency of ventilation (as measured by an indicator that included ventilatory pressures and CO2 values) nearly twofold (P < 0.05). Lung volumes, measured from deflation pressure-volume curves, also increased (P < 0.05). However, the 2 mg/kg dose caused severe pulmonary interstitial emphysema in 5 of 13 lambs, suggesting adverse effects. An intravascular fetal dose of 12.5 mg/kg hydrocortisone or an intramuscular dose of 0.1 mg/kg betamethasone had no effect on postnatal lung function. In separate studies, the 2 mg/kg dose improved all indicators of lung function almost twofold after only 24 h of fetal exposure and delivery at 128 days gestational age (P < 0.01). There was a dose-dependent suppression of the postnatal cortisol surge in treated animals, although fetal treatment did not alter cord cortisol levels. Single-dose fetal hormone treatments can cause large and rapid improvements in postnatal lung function in preterm lambs.
Keyword Betamethasone
Lung maturation
Respiratory distress syndrome
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: Faculty of Health and Behavioural Sciences -- Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 92 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 0 times in Scopus Article
Google Scholar Search Google Scholar
Created: Wed, 17 Nov 2010, 11:34:01 EST