Department of Pediatrics, Pediatric Nephrology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Thuringia, Germany.
Department of Obstetrics and Gynecology, University Hospital Jena, Jena, Thuringia, Germany.
Pediatr Nephrol. 2023 Nov;38(11):3635-3643. doi: 10.1007/s00467-023-05988-w. Epub 2023 May 23.
Renal oligohydramnios (ROH) describes an abnormally low volume of amniotic fluid (AF) during pregnancy. ROH is mostly caused by congenital fetal kidney anomalies. The ROH diagnosis frequently implies an increased risk of peri- and postnatal fetal mortality and morbidity. The present study aimed to evaluate the impact of ROH on pre-and postnatal development in children with congenital kidney anomalies.
This retrospective study included 168 fetuses with anomalies in the kidney and urinary tract. Based on the amount of AF measured by ultrasound, patients were divided into three groups: normal amniotic fluid (NAF), amniotic fluid in the lower normal range (LAF), and ROH. These groups were compared with respect to prenatal sonographic parameters, perinatal outcomes, and postnatal outcomes.
Among the 168 patients with congenital kidney anomalies, 26 (15%) had ROH, 132 (79%) had NAF, and 10 (6%) had LAF. Of the 26 families affected by ROH, 14 (54%) decided to terminate pregnancy. Of 10 live-born children in the ROH group, 6 (60%) survived the observation time; of these, 5/6 presented with chronic kidney disease, stages I-III, at their last examination. The main differences in postnatal development between the ROH group and the NAF and LAF groups were: restricted height and weight gain, respiratory issues, complicated feeding, and the presence of extrarenal malformations.
ROH is not a mandatory indicator of severe postnatal kidney function impairment. However, children with ROH have complicated peri-and postnatal periods, due to the presence of concomitant malformations, which must be considered in prenatal care. A higher resolution version of the Graphical abstract is available as Supplementary information.
肾羊水过少（ROH）是指妊娠期间羊水体积异常低。ROH 主要由先天性胎儿肾脏异常引起。ROH 的诊断通常意味着围产期和产后胎儿死亡率和发病率增加的风险增加。本研究旨在评估 ROH 对先天性肾脏异常儿童产前和产后发育的影响。
本回顾性研究纳入了 168 例肾脏和泌尿道异常的胎儿。根据超声测量的羊水量，患者分为三组：正常羊水（NAF）、羊水在正常下限（LAF）和 ROH。比较三组产前超声参数、围产儿结局和产后结局。
在 168 例先天性肾脏异常患者中，26 例（15%）有 ROH，132 例（79%）有 NAF，10 例（6%）有 LAF。在 26 个受 ROH 影响的家庭中，有 14 个（54%）决定终止妊娠。在 ROH 组的 10 名活产儿中，有 6 名（60%）存活至观察期结束；其中 5/6 名在最后一次检查时患有慢性肾脏病 I-III 期。ROH 组与 NAF 和 LAF 组在产后发育方面的主要差异为：身高和体重增长受限、呼吸问题、喂养复杂和存在肾外畸形。
ROH 并不是严重产后肾功能损害的强制性指标。然而，由于存在伴发畸形，ROH 患儿围产期和产后期间较为复杂，在产前护理中必须考虑到这些问题。更清晰的图表可在补充信息中查看。
