Serial Amnioinfusion as Regenerative Therapy for Pulmonary Hypoplasia in Fetuses With Intrauterine Renal Failure or Severe Renal Anomalies: Systematic Review and Future Perspectives

Warring, Simrit K.; Novoa, Victoria Arruga Novoa y; Shazly, Sherif; Trinidad, Mari Charisse; Sas, David J.; Schiltz, Brenda; Prieto, Mikel; Terzic, André; Ruano, Rodrigo

doi:10.1016/j.mayocpiqo.2020.04.008

Cited by 11 publications

(6 citation statements)

References 52 publications

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“…Двусторонняя агенезия почек встречается с частотой около 1-3 на 10 000 новорожденных [4,7,8]. Помимо синдрома Поттера, ДПА может включаться в состав более 70 синдромов и клинических состояний (Майер -Рокитанского -Кюстер -Хаузера, Паллистера -Холла, гетеротаксия и др.)…”

Section: Discussionunclassified

“…К тому же на сегодняшний день известно лишь об одном выжившем ребенке в возрасте 9 мес., перенесшем серийные амниоинфузии и находящемся на перитонеальном диализе, в ожидании трансплантации почек. Таким образом, учитывая отсутствие доказательной базы и отсроченных результатов, а также психологические и этические аспекты САИ, данный вид вмешательства пока не может рассматриваться в качестве метода лечения детей с синдромом Поттера [2,4,6,8,[15][16][17].…”

Section: Discussionunclassified

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A case report of Potter’s syndrome in a newborn

Shidakov¹,

Shavtikova²,

Dzhibabova³

2021

Medicinskij sovet

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Introduction. Potter’s sequence is a very rare and severe syndromic complex that includes congenital kidney defects leading to oligohydramnios, lung hypoplasia and structural skeletal disorders. Clinical case presentation: observation of a boy born from the 5th pregnancy to the mother at 37 weeks. Antenatally, the fetus was found to have bilateral renal and urinary bladder agenesis, malformations of the limbs, but the parents refused to terminate the pregnancy. After birth, the child was diagnosed with Potter’s syndrome with severe hypoplasia of the lungs, which required mechanical ventilation. In 2 hours after birth, the child developed a tension pneumothorax, which was arrested by performing drainage of the pleural cavity. During the day, the patient received complex treatment in the intensive care unit, despite which, by the 2nd day of life, the death of the child occurred. Currently, there are no guidelines for the treatment of Potter syndrome with proven positive long-term outcomes.Discussion. Children with Potter syndrome do not have the same set of symptoms, but they develop a chain of events leading to a common ultimate result - decreased amount of amniotic fluid. Abnormalities leading to oligohydramnios may include severe hypoplasia, dysplasia, polycystic, obstructive uropathy or renal agenesis. In most cases, the disease occurs sporadically, but there are also forms with transmission of the disorder through successive generations: autosomal dominant or recessive inheritance of polycystic disease, hereditary renal dysplasia caused by mutations in RET, UPK3A genes and other chromosomal abnormalities.Conclusion. Potter syndrome is a set of severe syndromes manifested by abnormalities in the development of kidneys, oligohydramnios, leading to lung hypoplasia, skeletal disorders and other congenital anomalies. The severity of congenital defects included in the set depends on the time periods when oligohydramnios occurred. Despite the availability of experimental therapies, the disease is now considered to be fatal.

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Section: Discussionunclassified

A case report of Potter’s syndrome in a newborn

Shidakov¹,

Shavtikova²,

Dzhibabova³

2021

Medicinskij sovet

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“…A systemic review was performed by Warring, et al on serial amnioinfusion therapy, in cases of oligohydramnios diagnosed at early gestational age secondary to LUTO or chronic renal anomalies. The review concluded serial amnioinfusion therapy can reduce the risk of newborn mortality due to pulmonary compromise [10].…”

Section: Discussionmentioning

confidence: 99%

Antenatal Management of Second Trimester Oligohydramnios and Evolving Abnormal Ultrasound Findings: Case Report

Roshan¹,

Ellen²,

Plonka³

et al. 2020

Obstet Gynecol Cases Rev

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Appropriate patient selection for prenatal intervention in the setting of abnormal antenatal ultrasound findings remains challenging. This case illustrates the course of a complicated pregnancy in a 35-year-old gravida 1 para 0 who presented to our Maternal-Fetal-Medicine clinic at 24.2 weeks gestation with fetal ascites, scalp edema, and oligohydramnios. Her first trimester ultrasound and genetic screening was normal. The patient was counseled that the observed findings carried a high chance for fetal demise or postnatal birth defects and complications. The patient chose to continue the pregnancy and opted for any necessary fetal interventions. Throughout the course of her pregnancy, multiple therapeutic interventions were performed in order to maintain a stable fetal environment, including intrauterine paracentesis, transabdominal amnioinfusion, vesicocentesis, and placement of a peritoneal amniotic shunt. The purpose of this case report is to investigate the role of fetal intervention in second trimester abnormal ultrasound findings and improve the quality of future prenatal consultation and therapy.

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“…There is no clear standard of care for kidney agenesis and neonatal end-stage kidney failure. To our knowledge, there have been 11 published clinical case reports of anhydramnios successfully treated by amnioinfusion to promote lung development and allow sufficient pulmonary function to survive the immediate postnatal period . However, the majority of these cases fail to fully address these infants’ long-term kidney failure and their dialysis outcomes.…”

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confidence: 99%