Successful In Utero Intervention for Bilateral Renal Agenesis

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 124; no. 2 Suppl 1; pp. 413 - 415
• Main Authors: Bienstock, Jessica L., Birsner, Meredith L., Coleman, Fred, Hueppchen, Nancy A.
• Format: Journal Article
• Language: English
• Published: United States by The American College of Obstetricians and Gynecologists 01.08.2014
• Subjects: Abnormalities, Multiple - etiology; Abnormalities, Multiple - prevention & control; Adult; Congenital Abnormalities - therapy; Female; Fetal Diseases - therapy; Fetal Therapies; Humans; Infant, Newborn; Kidney - abnormalities; Kidney Diseases - complications; Kidney Diseases - congenital; Kidney Diseases - therapy; Lung - abnormalities; Lung Diseases - etiology; Lung Diseases - prevention & control; Peritoneal Dialysis; Pregnancy
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/AOG.0000000000000339

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.