[lst report: Alternatives to cortisone therapy. lst clinical experiences with a carnitine-betamethasone combination for the stimulation of fetal lung maturity].

In the recent past criticism has been voiced with regard to the efficacy and possible side effects of corticosteroid prophylaxis of fetal respiratory distress syndrome (RDS). Apparently the efficacy of this treatment has been over-estimated and the spectrum of possible side effects has not received enough critical attention. In view of the multiple indications that the fetal metabolism, above all, may be altered by this type of therapy, it seems necessary to search for other methods of surfactant stimulation. This paper presents the first clinical study on the use of carnitine (4 g for 5 days in combination with twice 8 mg beta-methasone versus twice 8 mg betamethasone alone). The patients on combination therapy showed a more marked increase in surfactant content of the amniotic fluid. Lung compliance determination in infants born within 72 hours of completion of therapy also revealed better results in the combination therapy group. There were also fewer clinically demonstrable RDS cases in this group. More research will be necessary to definitely establish the value of this new form of therapy.