Indications for CD included fetal distress (n=7), breech presentation (n=5), anhydramnios
(n=3), failed induction of labour (n=3), previous CD x1 (n=4), previous CD x2 (n=2), poor progress of labour (n=2), cord prolapse (n=1), high parity (n=1) and very low fetal weight (n=1).
22,26,34,60,64,65) Oligohydramnios or anhydramnios
, hydrops fetalis, pulmonary hypoplasia, cryptorchidism, and fetal death are also reported.
A total of 4 patients had a termination of pregnancy, 3 for confirmed chromosomal abnormalities as detailed above, and 1 for spontaneous rupture of membranes and anhydramnios
at an early, non-viable gestation.
She had a past history of emergency caesarean section in 2011 at 35 weeks of gestation due to anhydramnios
and pregnancy induced hypertension.
Ultrasound features are early anhydramnios
from 16 weeks of gestation onwards, absence of bladder filling, and empty lumbar fossae.
Also, oligohydramnios and anhydramnios
were seen in two fetuses.
Of the 10 fetuses with follow-up data, the option of termination was offered in 6 cases of anhydramnios
, including 3 cases with signs of infravesical obstruction (a possible posterior urethral valve (PUV) and poor prognostic factors and 3 cases with unilateral hydronephrosis and increased echogenicity in the contralateral kidney.
Terminated cases, because of associated severe / lethal extra-cardiac pathologies (Group A) Pathological classification n = 39 Clinical diagnosis (n) Chromosomal pathologies 23 Trisomy 21 (n=13), trisomy 18 (n=8), trisomy 13 (n=2) Genitourinary pathologies 6 Bilateral renal agenesis (n=2), multicystic dysplastic kidneys associated with oligo- / anhydramnios
(n=4) Central nervous system 7 Anencephaly (n=1), pathologies holoprosencephaly (n=2), hemivertebra (n=l), vermis agenesis (n=1), neural tube defect (n=2) Other 3 Severe generalized hydrops / septated cystic hygroma (n=3) Table 3.
A decline in blood volume for the donor twin leads to decreased urine output to the extent that bladder filling virtually ceases and oligohydramnios may progress to anhydramnios
Although no congenital malformations were observed, fetal renal toxicity, as evidenced by oligohydramnios or anhydramnios
, was observed in three cases.
Be aware, however, that instillation of the dye is very difficult in cases of severe oligohydramnios or anhydramnios