Neonatal Survival After Serial Amnioinfusions for Anhydramnios Due to Fetal Kidney Failure

Can serial amnioinfusions instituted before 26 weeks’ gestation mitigate lethal pulmonary hypoplasia and enable survival in neonates with anhydramnios due to fetal kidney failure, excluding bilateral renal agenesis?In this nonrandomized clinical trial, the primary outcome of neonatal survival to 14 days or longer with dialysis access was achieved for 19 of 29 live-born neonates (65.5%) with fetal kidney failure not due to bilateral renal agenesis. Longer-term infant survival was lower, with 48% surviving to hospital discharge; serial amnioinfusions were not associated with significant maternal complications.Prenatal serial amnioinfusions can mitigate lethal pulmonary hypoplasia among neonates with fetal kidney failure, but survivors still face substantial morbidity and mortality independent of lung function.

Corresponding Author: Meredith A. Atkinson, MD, MHS, Division of Pediatric Nephrology, The Johns Hopkins University School of Medicine, 200 N Wolfe St, Room 3064, Baltimore, MD 21287 (matkins3@jhmi.edu).

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