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Outcome of pregnancies complicated by oligohydramnios or anhydramnios of renal origin
Author(s) -
Grijseels E. W. M.,
vanHornstra PTM Echteld,
Govaerts L. C. P.,
CohenOverbeek T. E.,
de Krijger R. R.,
Smit B. J.,
Cransberg K.
Publication year - 2011
Publication title -
prenatal diagnosis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.956
H-Index - 97
eISSN - 1097-0223
pISSN - 0197-3851
DOI - 10.1002/pd.2827
Subject(s) - oligohydramnios , medicine , hydronephrosis , renal dysplasia , renal function , obstetrics , pregnancy , gestational age , dysplasia , fetus , retrospective cohort study , gynecology , kidney , urinary system , genetics , biology
Objective To evaluate the outcome of fetuses with oligohydramnios due to kidney anomalies. Methods A retrospective study was performed of all pregnancies diagnosed with oligohydramnios and associated kidney anomalies during the period 2000–2008. Outcome included pregnancy outcome, mortality, and morbidity. Morbidity included renal function based on the glomerular filtration rate (GFR) during follow‐up. Results A total of 71 pregnancies were evaluated; 36 fetuses presented on ultrasound with cystic dysplasia, 15 with polycystic kidney disease (PKD) and 20 with hydronephrosis. Twenty‐three (32%) had associated anomalies. In 49 fetuses (69%), the diagnosis had been made before 24 weeks of gestational age (GA); 41 of those pregnancies were terminated. Twenty‐five neonates were live born: 10 survived, 15 died. Prognostic factors for survival included GA at diagnosis (32.2 weeks for survivors vs 28.1 weeks for non‐survivors; P = 0.02), diagnosis of hydronephrosis (7 in the survivors vs 4 in the non‐survivors: P = 0.05), isolated anomaly (9 in the survivors vs 7 in the non‐survivors: P = 0.04). Severity of oligohydramnios (1 case of anhydramnios in the survivors vs 7 in the non‐survivors: P = 0.08) was not significant. The 1‐year GFR was below 50 mL/min.1.73 m 2 in four of the ten survivors. Conclusion The prognosis of early onset renal oligohydramnios is poor. Predictive determinants of survival are: GA at diagnosis, nature of renal anomaly (hydronephrosis vs other), and presence of associated anomalies. Copyright © 2011 John Wiley & Sons, Ltd.