Evidence map›Paper›PMID 38857574›Full record

ArticleFetal diagnosis and therapy2025

Comparison of Serial Amnioinfusion Strategies for Isolated Early-Onset Fetal Renal Anhydramnios.

Joyce M Cheng, Ahmet A Baschat, Meredith A Atkinson, Mara Rosner, Michelle L Kush, Denise Wolfson, Sarah Olson, Kristin Voegtline, Lindsey Goodman, Angie C Jelin and 1 more

Abstract readComparative Study
In one paragraph

Article in Fetal diagnosis and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Joyce M ChengJohns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ahmet A BaschatCenter for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Meredith A AtkinsonDivision of Pediatric Nephrology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mara RosnerCenter for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Michelle L KushCenter for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Denise WolfsonCenter for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Sarah OlsonBiostatistics, Epidemiology and Data Management Core, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Kristin VoegtlineBiostatistics, Epidemiology and Data Management Core, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Lindsey GoodmanCenter for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Angie C JelinDivision of Maternal-Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Jena L MillerCenter for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Funding

Renal Anhydramnios Fetal Therapy (RAFT) TrialR01HD100540 · NICHD · JOHNS HOPKINS UNIVERSITY · PI ATKINSON, MEREDITH ANN, MILLER, JENA L · 2020 to 2024
$3.2M
Single gene pathogenic variants associated with BEEC (Bladder Exstrophy, Epispadias, Complex)K23DK119949 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI JELIN, ANGIE CHILD · 2019 to 2023
$1.1M
NICHD NIH HHS R01 HD100540NIDDK NIH HHS K23 DK119949
6 · The paper itself

Abstract

introductionThe optimal protocol for serial amnioinfusions to maintain amniotic fluid in pregnancies with early-onset fetal renal anhydramnios before 22 weeks is not known. We compared the performance of two different approaches.

methodsA secondary analysis was conducted of serial amnioinfusions performed by a single center during the external pilot and feasibility phases of the Renal Anhydramnios Fetal Therapy (RAFT) trial. During the external pilot, higher amnioinfusion volumes were given less frequently; in the feasibility study, smaller volume amnioinfusions were administered more frequently. Procedural details, complications, and obstetric outcomes were compared between the two groups using Pearson's χ2 or Fisher's exact tests for categorical variables and Student's t tests or Wilcoxon rank-sum tests for continuous variables. The adjusted association between procedural details and chorioamniotic separation was obtained through a multivariate repeated measure logistic regression model.

resultsEleven participants underwent 159 amnioinfusions (external pilot: 3 patients, 21 amnioinfusions; feasibility: 8 patients, 138 amnioinfusions). External pilot participants had fewer amnioinfusions (7 vs. 19.5 in the feasibility group, p = 0.04), larger amnioinfusion volume (750 vs. 500 mL, p < 0.01), and longer interval between amnioinfusions (6 [4-7] vs. 4 [3-5] days, p < 0.01). In the external pilot, chorioamniotic separation was more common (28.6% vs. 5.8%, p < 0.01), preterm prelabor rupture of membranes (PPROM) occurred sooner after amnioinfusion initiation (28 ± 21.5 vs. 75.6 ± 24.1 days, p = 0.03), and duration of maintained amniotic fluid between first and last amnioinfusion was shorter (38 ± 17.3 vs. 71 ± 19 days, p = 0.03), compared to the feasibility group. While delivery gestational age was similar (35.1 ± 1.7 vs. 33.8 ± 1.5 weeks, p = 0.21), feasibility participants maintained amniotic fluid longer.

conclusionSmall volume serial amnioinfusions performed more frequently maintain normal amniotic fluid volume longer because of delayed occurrence of PPROM.

Indexed as

Amniotic FluidFetal TherapiesOligohydramniosAdultFeasibility StudiesFemaleHumansPilot ProjectsPregnancyAmnioinfusionAnhydramniosBilateral renal agenesisCongenital anomalies of the kidney and urinary tractFetal therapyPreterm prelabor rupture of membranes

Identifiers

PMID38857574
PMCPMC11628636

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.