DIABETIC MOTHER + INSULIN + SURFACTANT +RDS

SURFACTANT secreted by type- II pneumocyte is a surface tension lowering agent within the alveolus. It composed of LIPID 85%, PROTEIN 15%, others (CARBOHYDRATES, ELECTROLYTES) 2%.Among electrolytes Ca⁺⁺ is predominant.

There are four unique proteins in Surfactant Such as SP-A, SP-B, SP-C &SP-D. (SP= Surfactant Protein)

In DIABETIC MOTHER there is increase glucose in circulation, to maintain normal glucose level INSULIN is given as treatment. Sometimes it may cause HYPERINSULINISM in fetus.

Again insulin inhabits accumulation of SP-A protein in fetal lung tissue. So production of defective surfactant hampers gaseous exchange between alveolus & pulmonary capillary bed. This condition known as Respiratory Distress Syndrome (RDS: sign /symptoms-tachypnoea, tachycardia, flaring of nostril, cyanosis) of Infants.

Previously Respiratory Distress Syndrome (RDS) known as HYALINE MEMBRANE DISEASES. Because of-

(Microscopically, a pulmonary surfactant deficient lung is characterized by collapsed air-spaces alternating with hyper-expanded areas, vascular congestion and, in time, hyalinemembranes. Hyaline membranes are composed of fibrin, cellular debris, red blood cells, rare neutrophils and macrophages. They appear as an eosinophilic, amorphous material, lining or filling the air spaces and blocking gas exchange. As a result, blood passing through the lungs is unable to pick up oxygen and unload carbon dioxide. Blood oxygen levels fall and carbon dioxide rises, resulting in rising blood acid levels and hypoxia. Structural immaturity, as manifest by decreased number of gas-exchange units and thicker walls, also contributes to the disease process. Therapeutic oxygen and positive-pressure ventilation, while potentially life-saving ;;;From Wikipedia.)

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