AMNIOINFUSIONS IN RENAL AGENESIS

Background: penal agenesis causes severe oligohydramnios, which result s in compression effects, lung hypoplasia, and rapid neonatal death. C ase: We report a case of renal agenesis identified in a fetus in which serial amnioinfusions were employed to prevent pulmonary hypoplasia a nd compression effects. A total of ten amnioinfusions were performed b etween 17-33 weeks' gestation. Chorioamnionitis led to preterm deliver y at 33 weeks. The infant had no significant pulmonary hypoplasia and none of the compression effects usually associated with the oligohydra mnios sequence. Peritoneal dialysis was provided for the infant with a long-term aim of eventual renal replacement therapy, but dialysis was unsuccessful and the infant died at the age of 23 days. Autopsy revea led slightly small lungs and extensive cavitating lesions in the brain , which were presumed to be of peripartum or antenatal origin. The cha in of events leading to this unusual course of action is described, an d the ethical aspects are outlined. Conclusion: At present, this type of procedure is not an appropriate intervention in cases of renal agen esis, and such management is strongly discouraged.