Antenatal corticosteroids and intra-amniotic surfactant administration

Antenatal maternal corticosteroid administration is worldwide accepted alternative for the prevention of respiratory distress syndrome (RDS) in premature neonates. Ultrasonography (US) - guided single direct fetal intramuscular injection of betamethasone and intra-amniotic fluid administration of surfactant for the prophylaxis of RDS was developed at our perinatal unit and applied in high-risk pregnancies. Direct fetal steroid and intra-amniotic surfactant treatment decreased the incidences of severe RDS, the duration of ventilatory support was shorter, and the survival rate was improved. US-guided fetal steroid or intra-amniotic surfactant treatment seem to have great potential for becoming clinically relevant approaches to improve fetal lung maturation.