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Amnioinfusions in renal agenesis

D Cameron1, B A Lupton, D Farquharson

  • 1Department of Pediatrics, University of British Columbia, British Columbia's Children's Hospital, Vancouver, Canada.

Obstetrics and Gynecology
|May 1, 1994
PubMed
Summary
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Serial amnioinfusions in a fetus with renal agenesis aimed to prevent complications but were ultimately unsuccessful. This management approach is strongly discouraged for renal agenesis cases.

Area of Science:

  • Perinatology
  • Fetal Medicine
  • Neonatal Care

Background:

  • Renal agenesis leads to severe oligohydramnios, causing fetal compression effects and lung hypoplasia.
  • These complications often result in rapid neonatal mortality.

Observation:

  • A case report details serial amnioinfusions in a fetus diagnosed with renal agenesis.
  • Ten amnioinfusions were administered between 17-33 weeks' gestation to mitigate pulmonary hypoplasia and compression.
  • Despite interventions, preterm delivery occurred at 33 weeks due to chorioamnionitis.

Findings:

  • The infant exhibited no significant pulmonary hypoplasia or compression effects typically seen in oligohydramnios.
  • Peritoneal dialysis was initiated with the goal of renal replacement therapy but proved unsuccessful.

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  • The infant expired at 23 days; autopsy revealed slightly small lungs and brain lesions.

    • Implications:

    • Current evidence suggests amnioinfusions are not appropriate for managing renal agenesis.
    • This management strategy is strongly discouraged in clinical practice.
    • Further research is needed to explore effective interventions for fetal renal agenesis.