New Anhydramnios after 22 Weeks and Pulmonary Hypoplasia

Authors

• Aaron W Roberts
• Margaret Clement
• Suzanne Marie Lopez
• Rita Swinford
• Percy Pacora Portella
• Edgar Hernandez-Andrade
• Matthew Rysavy
• Anthony Johnson

Language

English

Publication Date

1-1-2025

Journal

Fetal Diagnosis and Therapy

DOI

10.1159/000546988

PMID

40550221

PMCID

PMC12306945

PubMedCentral® Posted Date

6-23-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Introduction: Anhydramnios due to renal failure prior to 22 weeks of gestational 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 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 nonrenal malformations were excluded.

Results: During the study period 53,698 s 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. 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.

Keywords

Humans, Female, Pregnancy, Retrospective Studies, Lung, Lung Diseases, Ultrasonography, Prenatal, Infant, Newborn, Gestational Age, Oligohydramnios, Pregnancy Trimester, Second, Adult, Abnormalities, Multiple, Anhydramnios, Pulmonary hypoplasia, Renal failure, Fetal intervention, Amnioinfusion, Shunt, Lower urinary tract obstruction

Published Open-Access

yes

Recommended Citation

Roberts, Aaron W; Clement, Margaret; Lopez, Suzanne Marie; et al., "New Anhydramnios after 22 Weeks and Pulmonary Hypoplasia" (2025). Faculty, Staff and Student Publications. 3899.
https://digitalcommons.library.tmc.edu/uthmed_docs/3899