Study: Treatment could save lives of preborn babies with kidney condition

A new study confirms that amnioinfusion can be a life-saving treatment for preborn babies suffering from kidney defects or failure.

Key Takeaways:

• Anhydramnios is a condition in which there is no amniotic fluid in the womb, and is often related to kidney defects or failure.

• A new study looked at the effects of amnioinfusion on babies with anhydramnios.

• The study found that over 90% of the women who received amnioinfusion treatment delivered living babies, with nearly two-thirds who survived to receive dialysis.

The Details:

Medical Xpress reported on a study, published in the Journal of the American Medical Association (JAMA), in which researchers examined whether amnioinfusion — regular saline injections into the uterus — increases the chances of survival in preborn babies diagnosed with kidney defects or failure, leading to anhydramnios.

Anhydramnios typically occurs when a preborn baby's kidneys are not properly formed, which then leads to a lack of amniotic fluid in the uterus. This fluid is replenished by the baby's urine throughout pregnancy, and without functioning kidneys, the baby is unable to urinate.

This can be life-threatening, as amniotic fluid is necessary for the lungs to develop, and for the baby to practice breathing as the pregnancy progresses.

The Renal Anhydramnios Fetal Therapy (RAFT) trial was conducted in 13 medical centers across the country, though it was spearheaded by Johns Hopkins Children's Center.

"Without enough amniotic fluid, the fetus's lungs cannot develop properly, often leading to severe respiratory issues after birth," Meredith Atkinson, M.D., M.H.S., pediatric nephrologist at Johns Hopkins Children's Center and co-lead of the RAFT study, said.

Patients whose babies were experiencing kidney failure were enrolled into the trial, with 32 pregnant women ultimately participating. Regular amnioinfusions began at 26 weeks gestation, and while some babies were born prematurely, over 90% of trial participants gave birth to a living baby with 65% surviving for at least two weeks and undergoing dialysis.

"The RAFT trial marks an important step forward in fetal therapy. Building on this work, the RAFT 2 study explores how serial amnioinfusions may offer a new treatment pathway for patients with fetal renal failure, highlighting the value of a multidisciplinary approach and helping families make more informed decisions in complex situations."

Zoom Out:

Former U.S. Congresswoman Jaime Herrera Beutler (R-Wash.) was one of the first people to undergo this groundbreaking treatment, after her preborn child was diagnosed with Potter's syndrome, a condition resulting from insufficient amniotic fluid.

Previously, Potter's syndrome was considered fatal, and Beutler was urged to have an abortion. Instead, Beutler and her husband went to Johns Hopkins every week to receive amnioinfusion treatment, though it wasn't easy; after learning amnioinfusion was available, she said most hospitals wouldn't even consider it. But it saved their daughter's life.

“As soon as fluid was introduced to her face you could watch her chest fluctuate in and out. She was practice breathing,” Dan Beutler said at the time.

Herrera Beutler made it through just five weeks of amnioinfusions before going into premature labor at 28 weeks.

“Someone said ‘Look down at your baby,'” Herrera Beutler said. “We looked. She looked up at us, tiny, 2 pounds, 12 ounces. She looked up at us and she opened [her] mouth drew a breath, then cried. And that doesn’t happen if your lungs can’t breathe.”

Their daughter, named Abigail, became the first known baby to survive being born with no kidneys. She then survived on dialysis until she was able to receive a kidney transplant from her father. Abigail is now almost 13 years old and thriving.

The Bottom Line:

Medical advancements have increasingly been able to address conditions previously seen as fatal. Every child deserves to be given a fighting chance at life.