The use of saline solution as a contrast medium in suspected diaphragmatic hernia and renal agenesis

Martin C.H. Haeusler*, Greg Ryan, Stephen C. Robson, Shlomo Lipitz, Charles H. Rodeck

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Our purpose was to determine the value of saline solution instillation as a contrast medium in suspected congenital diaphragmatic hernia and renal agenesis. STUDY DESIGN: Intrathoracic (n = 3) or intraperitoneal (n = 2) instillation was performed in five cases of suspected congenital diaphragmatic hernia. Amnioinfusion combined with intraperitoneal instillation was performed in five cases of suspected renal agenesis. RESULTS: Instillation clearly demonstrated the diaphragmatic defect in four of the five cases. In the cases with suspected renal agenesis, amnioinfusion led to recognition of a previously unsuspected sirenomelia, and intraperitoneal instillation demonstrated empty renal fossae in four cases. The final fetus with bilateral renal agenesis was thought antenatally to have a contralateral multicystic kidney. CONCLUSIONS: We suggest that intrathoracic or intraperitoneal saline solution instillation is a useful diagnostic procedure in carefully selected cases where confident ultrasonic diagnosis is often difficult and yet would significantly alter management. In cases of severe oligohydramnios amnioinfusion is a complementary procedure. In 80% of cases in this series there was significant improvement in visualization after the procedure.

Original languageEnglish
Pages (from-to)1486-1492
Number of pages7
JournalAmerican Journal of Obstetrics and Gynecology
Volume168
Issue number5
DOIs
StatePublished - 1993
Externally publishedYes

Keywords

  • Fetal diseases
  • congenital diaphragmatic hernia
  • parenteral intrathoracic infusions
  • prenatal diagnosis methods
  • ultrasonography

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