Prostaglandin E1 before Elective Caesarean Section to reduce Transient Tachypnea of the Newborn (TTN) A Randomized Control Trial

Abstract

Newborn respiratory distress occurs in about 7% of deliver¬ies. The most common etiology of respiratory distress in newborns is TTN, which occurs in about five or six per 1,000 births. TTN results from delayed reabsorption and clearance of alveolar fluid. Post-delivery prostaglandin release distends lymphatic vessels, which removes lung fluid as pulmonary circula¬tion increases with the initial fetal breath. Cesarean delivery without labor bypasses this process and is therefore a risk factor for TTN. Catecholamines can stimulate pulmonary fluid reabsorption through acting upon beta-adrenergic receptors in foetal lung which present more late in gestation, and thus enable the secretion of surfactant. This surge of catecholamines can be provoked through prostaglandins given before caesarean section to pregnant females as those who are born vaginally are found to be adapted metabolically through a higher catecholamine level at birth. So, prostaglandins may be given about one hour before an elective caesarean section after excluding the presence of contraindication to their use to decrease the neonatal respiratory diseases current study included 300 cases with gestational age range between 38 weeks to less than 39 weeks the included cases were classified into 2 groups: study group included 150 case were given PG E1 control group included 150 case were given placebo. We found one positive cases for TTN in study group, and 3 positive case for TTN in control group results we got were insignificant. So we suggest taking more large sample in future studies

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