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Predictive factors for survival in patients with oligohydramnios secondary to antenatal kidney disease

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Abstract

Background

Renal oligohydramnios (ROH) is caused by bilateral congenital abnormalities, either of renal parenchymal or obstructive origin. ROH is a poor prognostic factor of neonatal survival; lung hypoplasia is reported to be the main cause of mortality. We aimed to describe the fetal morbidity and pre- and postnatal mortality in case of ROH due to renal congenital pathologies and to find predictive risk factors for morbidity and mortality.

Methods

All data were collected in Trousseau Hospital in the obstetric, neonatology, and pediatric nephrology units, from 2008 to 2020.

Results

We included 66 fetuses with renal parenchymal pathologies posterior urethral valves (PUV) (N = 25), bilateral kidney agenesis (N = 10), hypodysplasia (N = 16), and polycystic kidney disease (N = 10) causing oligohydramnios identified on antenatal ultrasound. Total pre- and postnatal mortality was 76% (50/66). Mortality, excepting termination of pregnancy (TOP), was 65%. The presence of pneumomediastinum and pneumothorax was not different in survivors and non-survivors. Fetuses with kidneys having features of hypodysplasia on ultrasound at T2 and those with oligohydramnios before 32 weeks GA had a higher risk of death. There was a significant difference in plasma creatinine of the surviving patients compared to the deceased patients, from day 3 onwards (183 µmol/L [88; 255] vs. 295 µmol/L [247; 326]; p = 0.038).

Conclusions

The main differences between survivors and non-survivors among patients with “renal oligohydramnios” were oligohydramnios detection before 32 weeks GA, dysplasia detection on the second trimester ultrasound, and increase of serum creatinine from day 3 onwards.

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Author notes

  1. Mathilde Baudin and Claire Herbez have contributed equally to the present manuscript.

Authors and Affiliations

  1. Pediatric Nephrology Unit, Trousseau Hospital- ORIGYNE- AP-HP.Sorbonne Université, Paris, France

    Mathilde Baudin, Claire Herbez, Cyrielle Parmentier, Jean Daniel Delbet & Tim Ulinski

  2. Pediatric Intensive Care Unit, Trousseau Hospital- ORIGYNE- AP-HP.Sorbonne Université, Paris, France

    Isabelle Guellec

  3. Fetal Medicine Department, Trousseau Hospital- ORIGYNE- AP-HP.Sorbonne Université, Paris, France

    Ferdinand Dhombres, Lucie Guilbaud & Jean Marie Jouannic

  4. Radiology Department, Trousseau Hospital- AP-HP.Sorbonne Université, Paris, France

    Catherine Garel & Eleonore Bondiaux

  5. Pediatric Nephrology, Trousseau Hospital- ORIGYNE- AP-HP.Sorbonne Université, 26 Av du Docteur Arnold Netter, Paris, 75012, France

    Tim Ulinski

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  1. Mathilde Baudin
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  2. Claire Herbez
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Correspondence to Tim Ulinski.

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Baudin, M., Herbez, C., Guellec, I. et al. Predictive factors for survival in patients with oligohydramnios secondary to antenatal kidney disease. Pediatr Nephrol 38, 1783–1792 (2023). https://doi.org/10.1007/s00467-022-05800-1

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  • DOI: https://doi.org/10.1007/s00467-022-05800-1

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