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Serial Amnioinfusion Therapy for Treatment of Congenital Bilateral Renal Agenesis-A Systematic Review

Adriana Baez1, Gabriele Tonni2, Chryso P Katsoufis3

  • 1Miller School of Medicine, University of Miami, Miami, Florida, USA.

Prenatal Diagnosis
|July 18, 2025
PubMed

Insights

Serial amnioinfusion therapy (SAT) for congenital bilateral renal agenesis (BRA) shows limited long-term survival benefits. While SAT may improve initial survival, advanced neonatal care is crucial for peripartum survivors.

Area of Science:

  • Perinatal Medicine
  • Neonatology
  • Medical Genetics

Background:

  • Congenital bilateral renal agenesis (BRA) is a severe condition with high perinatal mortality.
  • Serial amnioinfusion therapy (SAT) has been explored as a potential intervention for BRA.
  • The efficacy, safety, and ethical considerations of SAT for BRA require comprehensive evaluation.

Purpose of the Study:

  • To systematically review and analyze the outcomes of serial amnioinfusion therapy in cases of congenital bilateral renal agenesis.
  • To evaluate the maternal and fetal outcomes associated with SAT for BRA.
  • To explore the implications of SAT for BRA management and long-term neonatal survival.

Main Methods:

  • A systematic review adhering to PRISMA guidelines was conducted.
  • Inclusion criteria involved BRA diagnosis, therapeutic amnioinfusion, and reported maternal/fetal outcomes.
  • Data from 11 full-text studies (N=40) focusing on live births with outcome reports were analyzed.

Main Results:

  • The average number of SAT sessions was 9 per mother.
  • Median gestational age at delivery was 33.4 weeks.
  • Neonatal mortality was high at 82.5% (33/40), with 17.5% surviving at publication; nearly half died within 33 days.

Conclusions:

  • Serial amnioinfusion therapy for congenital bilateral renal agenesis offers short-term survival benefits but does not consistently improve long-term outcomes.
  • Significant advances in neonatal intensive care are necessary to enhance the long-term survival and well-being of peripartum survivors.
  • Further research is needed to optimize interventions and improve the prognosis for infants diagnosed with BRA.

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