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The use of saline solution as a contrast medium in suspected diaphragmatic hernia and renal agenesis
M C Haeusler1, G Ryan, S C Robson
1Fetal Medicine Unit, University College Hospital, London, England.
Objective:
Our purpose was to determine the value of saline solution instillation as a contrast medium in suspected congenital diaphragmatic hernia and renal agenesis.
Study Design:
Intrathoracic (n = 3) or intraperitoneal (n = 2) instillation was performed in five cases of suspected congenital diaphragmatic hernia. Amnioinfusion combined with intraperitoneal instillation was performed in five cases of suspected renal agenesis.
Results:
Instillation clearly demonstrated the diaphragmatic defect in four of the five cases. In the cases with suspected renal agenesis, amnioinfusion led to recognition of a previously unsuspected sirenomelia, and intraperitoneal instillation demonstrated empty renal fossae in four cases. The final fetus with bilateral renal agenesis was thought antenatally to have a contralateral multicystic kidney.
Conclusions:
We suggest that intrathoracic or intraperitoneal saline solution instillation is a useful diagnostic procedure in carefully selected cases where confident ultrasonic diagnosis is often difficult and yet would significantly alter management. In cases of severe oligohydramnios amnioinfusion is a complementary procedure. In 80% of cases in this series there was significant improvement in visualization after the procedure.