Outcome of pregnancies complicated by oligohydramnios or anhydramnios of renal origin
Outcome of pregnancies complicated by oligohydramnios or anhydramnios of renal origin
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DOI：
10.1002/pd.2827
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发表时间：
2011-11-01
影响因子：
3
通讯作者：
Cransberg, K.
中科院分区：
文献类型：
--
作者：
Grijseels, E. W. M.;van-Hornstra, P. T. M. Echteld;Cransberg, K.
目的探讨肾异常所致羊水过少的胎儿结局。方法回顾性分析2000- 2008年我院收治的羊水过少合并肾异常胎儿的妊娠结局、死亡率及并发症发生率。Mormorphology包括肾功能的基础上，肾小球滤过率（GFR）在follow-up.Results共71妊娠进行了评价; 36胎儿超声囊性发育不良，15与多囊肾病（PKD）和20与肾盂积水。23例（32%）有相关异常。在49例（69%）胎儿中，诊断是在孕龄（GA）24周之前进行的，其中41例终止妊娠，25例活产新生儿：10例存活，15例死亡。生存的预后因素包括诊断时GA（存活者32.2周vs非存活者28.1周; P = 0.02），肾积水诊断（存活者7例vs非存活者4例：P = 0.05），孤立异常（存活者9例vs非存活者7例：P = 0.04）。羊水过少的严重程度（存活者中1例羊水过少vs非存活者中7例：P = 0.08）不显著。10例存活者中4例1年GFR <50 mL/min，1.73m2。结论早发性肾性羊水过少预后差。生存率的预测性决定因素是：诊断时的GA、肾脏异常的性质（肾积水vs其他）和相关异常的存在。版权所有. (C)2011年约翰威利父子有限公司
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. (C) 2011 John Wiley & Sons, Ltd.