Causes of Renal Oligohydramnios: Impact on Prenatal Counseling and Postnatal Outcome

Overview

Journal Pediatr Nephrol

Specialties Nephrology
Pediatrics

Date 2017 Nov 13

PMID 29128922

Citations 6

Authors

Sebastian Loos

Markus J Kemper

Affiliations

Soon will be listed here.

Abstract

The presence of renal oligohydramnios (ROH) in a fetus has been associated in the past with a poor prognosis for survival, although recent studies have shown that survival has improved considerably due to the advances in neonatology and pediatric nephrology. In an article recently published in Pediatric Nephrology, evaluation of a large series by Mehler and colleagues confirms the improved prognosis, showing a survival rate of 32 of 38 (84%). In addition, only 12 of 35 (34%) neonates required renal replacement therapy. In five of these 12 children the dialysis could be terminated after the neonatal period. This study has important implications on the decision-making process and counseling of families. While 37% of families of the study opted for termination of pregnancies, palliative care was chosen by 8% of the families, representing an important option when a decision cannot be made rapidly by affected families. A multidisciplinary approach is not only necessary in the active treatment of neonates with a history of ROH but also in antenatal counseling. In this regard future efforts should establish consensus on an ethical framework for the decision-making process in ROH.

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References

Kozinszky Z, Sikovanyecz J, Pasztor N . Severe midtrimester oligohydramnios: treatment strategies. Curr Opin Obstet Gynecol. 2014; 26(2):67-76. DOI: 10.1097/GCO.0000000000000051. View

Magann E, Ounpraseuth S, Chauhan S, Ranganathan A, Dajani N, Bergstrom J . Correlation of ultrasound estimated with dye-determined or directly measured amniotic fluid volume revisited. Gynecol Obstet Invest. 2014; 79(1):46-9. DOI: 10.1159/000365088. View

Spaggiari E, Stirnemann J, Heidet L, Dreux S, Ville Y, Oury J . Outcome following prenatal diagnosis of severe bilateral renal hypoplasia. Prenat Diagn. 2013; 33(12):1167-72. DOI: 10.1002/pd.4217. View

Morris R, Malin G, Quinlan-Jones E, Middleton L, Diwakar L, Hemming K . The Percutaneous shunting in Lower Urinary Tract Obstruction (PLUTO) study and randomised controlled trial: evaluation of the effectiveness, cost-effectiveness and acceptability of percutaneous vesicoamniotic shunting for lower urinary tract.... Health Technol Assess. 2013; 17(59):1-232. PMC: 4781393. DOI: 10.3310/hta17590. View

Mehler K, Gottschalk I, Burgmaier K, Volland R, Buscher A, Feldkotter M . Prenatal parental decision-making and postnatal outcome in renal oligohydramnios. Pediatr Nephrol. 2017; 33(4):651-659. DOI: 10.1007/s00467-017-3812-3. View

Grijseels E, van-Hornstra P, Govaerts L, Cohen-Overbeek T, de Krijger R, Smit B . Outcome of pregnancies complicated by oligohydramnios or anhydramnios of renal origin. Prenat Diagn. 2011; 31(11):1039-45. DOI: 10.1002/pd.2827. View

Klaassen I, Neuhaus T, Mueller-Wiefel D, Kemper M . Antenatal oligohydramnios of renal origin: long-term outcome. Nephrol Dial Transplant. 2006; 22(2):432-9. DOI: 10.1093/ndt/gfl591. View

Biard J, Johnson M, Carr M, Wilson R, Hedrick H, Pavlock C . Long-term outcomes in children treated by prenatal vesicoamniotic shunting for lower urinary tract obstruction. Obstet Gynecol. 2005; 106(3):503-8. DOI: 10.1097/01.AOG.0000171117.38929.eb. View

Morris R, Malin G, Khan K, Kilby M . Antenatal ultrasound to predict postnatal renal function in congenital lower urinary tract obstruction: systematic review of test accuracy. BJOG. 2009; 116(10):1290-9. DOI: 10.1111/j.1471-0528.2009.02194.x. View

10.

Zaccara A, Giorlandino C, Mobili L, Brizzi C, Bilancioni E, Capolupo I . Amniotic fluid index and fetal bladder outlet obstruction. Do we really need more?. J Urol. 2005; 174(4 Pt 2):1657-60. DOI: 10.1097/01.ju.0000179538.85893.cb. View

11.

Gupta P, Kumar S, Sharma R, Gadodia A, Roy K, Sharma J . The role of magnetic resonance imaging in fetal renal anomalies. Int J Gynaecol Obstet. 2010; 111(3):209-12. DOI: 10.1016/j.ijgo.2010.07.024. View

12.

Poutamo J, Vanninen R, Partanen K, Kirkinen P . Diagnosing fetal urinary tract abnormalities: benefits of MRI compared to ultrasonography. Acta Obstet Gynecol Scand. 2000; 79(1):65-71. View

13.

Aulbert W, Kemper M . Severe antenatally diagnosed renal disorders: background, prognosis and practical approach. Pediatr Nephrol. 2015; 31(4):563-74. DOI: 10.1007/s00467-015-3140-4. View

14.

Melo B, Aguiar M, Bouzada M, Aguiar R, Pereira A, Paixao G . Early risk factors for neonatal mortality in CAKUT: analysis of 524 affected newborns. Pediatr Nephrol. 2012; 27(6):965-72. DOI: 10.1007/s00467-012-2107-y. View

15.

Hogan J, Dourthe M, Blondiaux E, Jouannic J, Garel C, Ulinski T . Renal outcome in children with antenatal diagnosis of severe CAKUT. Pediatr Nephrol. 2011; 27(3):497-502. DOI: 10.1007/s00467-011-2068-6. View

16.

Tsatsaris V, Gagnadoux M, Aubry M, Gubler M, Dumez Y, Dommergues M . Prenatal diagnosis of bilateral isolated fetal hyperechogenic kidneys. Is it possible to predict long term outcome?. BJOG. 2002; 109(12):1388-93. DOI: 10.1046/j.1471-0528.2002.02055.x. View

17.

Tomotaki S, Toyoshima K, Shimokaze T, Shibasaki J, Nagafuchi H . Association between cord blood cystatin C levels and early mortality of neonates with congenital abnormalities of the kidney and urinary tract: a single-center, retrospective cohort study. Pediatr Nephrol. 2017; 32(11):2089-2095. DOI: 10.1007/s00467-017-3733-1. View

18.

Dionne J, dAgincourt-Canning L . Sustaining life or prolonging dying? Appropriate choice of conservative care for children in end-stage renal disease: an ethical framework. Pediatr Nephrol. 2014; 30(10):1761-9. DOI: 10.1007/s00467-014-2977-2. View

19.

Spiro J, Konrad M, Rieger-Fackeldey E, Masjosthusmann K, Amler S, Klockenbusch W . Renal oligo- and anhydramnios: cause, course and outcome--a single-center study. Arch Gynecol Obstet. 2015; 292(2):327-36. DOI: 10.1007/s00404-015-3648-7. View

20.

Mehler K, Beck B, Kaul I, Rahimi G, Hoppe B, Kribs A . Respiratory and general outcome in neonates with renal oligohydramnios--a single-centre experience. Nephrol Dial Transplant. 2011; 26(11):3514-22. DOI: 10.1093/ndt/gfr046. View