Primary cause of hyaline membrane disease is
**Core Concept**
Hyaline membrane disease, also known as respiratory distress syndrome (RDS), is a leading cause of morbidity and mortality in preterm infants. It occurs due to an imbalance between the production and clearance of pulmonary surfactant, a complex mixture of phospholipids and proteins that reduces the surface tension within the lungs.
**Why the Correct Answer is Right**
The primary cause of hyaline membrane disease is the deficiency of surfactant protein B (SP-B) and surfactant protein C (SP-C), which are crucial for the formation and function of pulmonary surfactant. The lack of these proteins disrupts the normal lung development, leading to an increase in surface tension within the alveoli, making it difficult for the lungs to expand and breathe. This results in the collapse of the alveoli and the formation of hyaline membranes, which are characteristic of hyaline membrane disease.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because hyaline membrane disease is not caused by a deficiency of surfactant protein A (SP-A), which plays a role in the regulation of surfactant metabolism but is not the primary cause of RDS.
**Option B:** This option is incorrect because hyaline membrane disease is not caused by a deficiency of phospholipids, which are an essential component of pulmonary surfactant. However, the imbalance between phospholipids and proteins, particularly SP-B and SP-C, is the primary cause of RDS.
**Option C:** This option is incorrect because hyaline membrane disease is not caused by a deficiency of surfactant protein D (SP-D), which is involved in the regulation of surfactant metabolism and is not as critical as SP-B and SP-C for the formation and function of pulmonary surfactant.
**Clinical Pearl / High-Yield Fact**
The administration of surfactant therapy has significantly improved the outcomes of preterm infants with hyaline membrane disease, reducing the incidence of respiratory complications and mortality. The use of antenatal corticosteroids to promote fetal lung maturation has also become a standard practice in the management of preterm labor.
**Correct Answer: C. Surfactant protein C (SP-C) deficiency.**