P45Amnioinfusion and CFM in prenatal diagnosis of bilateral renal agenesis

Background Absence of ureteral bud formation during embryogenesis causes bilateral renal agenesis and occurs approximately 1:4000–5000 births. Severe oligohydramnios causes difficulties in apparent visualization. To improve the sonographic conditions the amnioinfusion and CFM of the renal arteries permits the accurate diagnosis. Methods We present the case report of 18 weeks' gestation fetus. Sonography was extremely difficult because of anhydramnion, but fetal cardiac arrhythmia was confirmed and congenital renal agenesis was suspected. In order to facilitate visualization transabdominal amnioinfusion – instillation of cca 350 ml saline solution was successfully performed. Results After amnioinfusion fetal cardiac arrhythmia disappeared, fetal movements appeared. Amnioinfusion enhanced sonografic resolution of renal fossae, which confirmed bilateral renal agenesis and bilateral adrenal hyperplasia. CFM did not confirm renal arteriae in abdominal part of aorta. Conclusion Technique of transabdominal amnioinfusioin enable to define the specific cause of severe oligohydramnios or anhydramnios. Improvement in vizualisation after this procedure is very important for exact final diagnosis which can be enhanced by CFM.