New anhydramnios after 22 weeks and pulmonary hypoplasia.

IF 1.6 3区 医学 Q3 OBSTETRICS & GYNECOLOGY
Aaron W Roberts, Margaret Clement, Suzanne Marie Lopez, Rita Swinford, Percy Pacora Portella, Edgar Hernandez-Andrade, Matthew Rysavy, Anthony Johnson
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引用次数: 0

Abstract

Objective Anhydramnios due to renal failure prior to 22 weeks gestation age (WGA) is associated with lethal pulmonary hypoplasia but after 22 WGA outcomes are less clear. We evaluated whether these fetuses, with new anhydramnios after 22 weeks WGA, incur significant risk of severe neonatal pulmonary morbidity. Methods This retrospective study of singleton pregnancies diagnosed with new onset renal anhydramnios after 22 WGA following verifiable normal AFI on ultrasound before 22 WGA from 2021 to 2023. Cases with bilateral renal agenesis, premature rupture of membranes and non-renal malformations were excluded. Results During the study period 53,698 second trimester ultrasound examinations were performed, of which 82 patients had new anhydramnios after 22 weeks, and 6 met criteria for inclusion in the study. Renal anhydramnios in each was secondary to a lower urinary tract outlet obstruction (LUTO). Two of these (2/6, 33%) underwent procedures that corrected anhydramnios and survived, the rest suffered lethal pulmonary hypoplasia. Conclusion Onset of and persistent renal anhydramnios after 22 WGA is associated with lethal pulmonary morbidity. Although clinical trials to date have focused on intervention for patients with renal anhydramnios prior to 22 WGA, investigation of treatments those with renal anhydramnios after 22 WGA is warranted to mitigate severe pulmonary hypoplasia.

22周后新羊水和肺发育不全。
目的:胎龄22周(WGA)前肾衰羊水与致死性肺发育不全相关,但胎龄22周(WGA)后的结局不太清楚。我们评估了这些在WGA 22周后出现新羊水的胎儿是否会产生严重新生儿肺部疾病的显著风险。方法回顾性研究2021 ~ 2023年22 WGA前超声证实AFI正常、22 WGA后诊断为新发肾性羊水的单胎妊娠。排除双侧肾发育不全、胎膜早破及非肾畸形的病例。结果在研究期间共进行了53,698次孕中期超声检查,其中82例在22周后出现新的羊水,6例符合纳入研究标准。肾性羊水无均继发于下尿路出口梗阻(LUTO)。其中2例(2/ 6,33 %)接受了纠正羊水无的手术并存活,其余的则发生了致死性肺发育不全。结论22例WGA术后并发持续性肾性羊水无与致死性肺部疾病相关。尽管迄今为止的临床试验主要集中在对22岁前肾性羊水无患者的干预,但对22岁后肾性羊水无患者的治疗研究是有必要的,以减轻严重的肺发育不全。
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来源期刊
Fetal Diagnosis and Therapy
Fetal Diagnosis and Therapy 医学-妇产科学
CiteScore
4.70
自引率
9.10%
发文量
48
审稿时长
6-12 weeks
期刊介绍: The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.
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