We have reported recently that the amniotic fluid concentrations of the surfactant components Sat. PC and SP-A are decreased in pregnancies with fetuses diagnosed with CDH (Am J Ob Gyn 173:1401, 1995). In addition, it has been suggested that surfactant therapy may be beneficial in the treatment of CDH. However, there is limited data on actual measurements of surfactant components in TF from infants with CDH. The aim of our study was to determine the concentrations of Sat. PC using thin-layer chromatography after osmium tetroxide treatment, and of SP-A by an ELISA method using a rabbit anti-human SP-A polyclonal antibody, in TF obtained during the first day after birth from intubated neonates with CDH (n= 10, mean GA 37.2 weeks, range 29-40 weeks). Also, we made similar determinations in TF samples from preterm infants with respiratory distress syndrome (RDS, n= 10, mean GA 28.4 weeks, range 26-32 weeks) and term neonates intubated for meconium aspiration syndrome (MAS, n=11, mean GA 40.5 weeks, range 37-43 weeks). All cases of CDH occurred on the left side and 6 of them died. Results are shown in the Table as mean ± SEM (* p < 0.05 by Kruskal-Wallis). As we reported previously (Am J Resp Crit Care Med 150:1672, 1994), all infants with RDS had low concentrations of SP-A in TF, compared with none of the neonates with CDH or MAS. Levels of Sat. PC in TF were quite variable and did not differ between groups. The concentrations fo SP-A and Sat. PC were not different in neonates with CDH that survived or died. These data show that deficiency of surfactant components in TF from neonates with CDH is uncommon and does not correlate with outcome.

Table 1
Full size table