Pilocarpine HC1, a parasympathomimetic drug, was administered to pregnant white rabbits in a daily subcutaneous injection of 5 mg/kg on days 24 through 27 of gestation. Fetuses from these animals and from salineinjected controls were obtained by caesarean section a t day 28 of gestation. Light microscopic examination revealed thinner alveolar septa in the lungs of pilocarpine-treated fetuses and, morphometrically, a significant increase in the number of mature type I1 cells, both per unit area and per 1,000 lung cells of any kind. Examination by electron microscopy revealed that the alveolar epithelium of pilocarpine-treated fetuses demonstrated morphologic correlates of increased maturation. These included thinning of type I cells to form blood-air barriers and substantial reductions in the glycogen content of both epithelial cell types. Type I1 cells of pilocarpine-treated fetuses contained (as indicated by morphometric analysis) more and larger lamellar inclusion bodies, as well as more multivesicular bodies than those of controls. Biochemical determination indicated that the glycogen content of fetal lung, but not liver, was reduced significantly in the pilocarpine-treated group. The findings of this study indicate that maternal administration of pilocarpine results in increased maturation of the fetal alveolar epithelium, thus providing a basis for the autonomic manipulation of fetal lung maturation.It is well established that immaturity of the lung is the primary etiologic factor predisposing to.the development of the respiratory distress syndrome of the newborn, the primary cause of death in premature infants (Gluck and Kulovich, '73). The overall maturity of the fetal lung has been found to depend to a great extent on the maturity of the type I1 epithelial cells of the alveolus. These cells are the recognized source of lung surfactant, a surface tension lowering substance, rich in dipalmitoyl phosphatidylcholine, which lines the alveolar space (for review see Farrell and Avery, '75).The type I1 cells contain characteristic lamellar inclusion bodies, the intracellular storage form of surfactant, as well as other secretory elements including rough endoplasmic reticulum, Golgi apparatus and multivesicular bodies, the presumed precursors of lamellar inclusion bodies. (Olsen, '72) and an acceleration of lecithin turn-over (Morgan and Morgan, '73). In addition, Massaro ('75) found that pilocarpine stimulated the release of protein into the surface-active fraction of rabbit lungs.There is little information available concerning the effects of pilocarpine on the surfactant system of fetal animals. However, physiologic evidence has indicated that pilocarpine does lower the surface tension in lungs of fetal rabbits, presumably by increasing the secretion of surfactant (Corbet et al., '76). In addition, recent studies have indicated that pilocarpine stimulates surfactant release from fetal rat lung in culture (Pysher et al., '77). The present study was designed to investigate the reactions of the deve...