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Successful in utero intervention for bilateral renal agenesis
Jessica L Bienstock1, Meredith L Birsner, Fred Coleman
1Johns Hopkins University School of Medicine, Baltimore, Maryland, and Legacy Maternal Fetal Medicine, Vancouver, Washington.
Background:
We report a case of bilateral renal agenesis treated with serial amnioinfusion in which the newborn survived the newborn period and was able to undergo peritoneal dialysis as a bridge to planned renal transplantation.
Case:
A 34-year-old woman, gravida 1 para 0, presented at 23 1/7 weeks of gestation with a diagnosis of anhydramnios and bilateral renal agenesis. The patient underwent weekly serial amnioinfusion with the goal of improving fetal pulmonary development. At 28 weeks of gestation, the patient delivered a live newborn who required minimal respiratory support. The neonate is currently 9 months old and is undergoing daily peritoneal dialysis.
Conclusion:
Serial amnioinfusion appears to have mitigated the severe pulmonary compromise that has, in the past, led to the death of newborns with bilateral renal agenesis.
