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We found a significant advantage to the administration of the initial dose of surfactant as prophylaxis rather than as rescue therapy in very premature infants.

Survival to discharge to home was similar with immediate bolus and postventilatory aliquot strategies for surfactant prophylaxis. Because of its logistical advantages in the delivery room and its beneficial effects on prolonged oxygen requirements, we recommend the postventilatory aliquot strategy for surfactant prophylaxis of premature infants delivered before 29 weeks' gestation.

SUMMARY We studied 91 offspring of ABO incompatible pregnancies and 30 controls resulting from 0-0 pregnancies to test whether cord bilirubin levels could be used to predict the severity of hyperbilirubinaemia in ABO incompatibility. Blood group, direct Coombs's test, and serum bilirubin estimations were carried out on cord blood, and bilirubin estimations at 12, 24, 36, and 48 hours of life.All newborns in whom the cord bilirubin was greater than 4 mg/100 ml (68 ,umol/l) developed severe hyperbilirubinaemia (levels >16 mg/100 ml (273 ,umol/l) at 12-36 hours) and required exchange transfusion. It is concluded that in ABO incompatibility infants with cord bilirubin level greater than 4 mg/100 ml represent a special 'high risk' category and should be placed in a centre where frequent re-evaluation and appropriate therapy are available.

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