The use of saline solution as a contrast medium in suspected diaphragmatic hernia and renal agenesis.
OBJECTIVE
Our purpose was to determine the value of saline solution instillation as a contrast medium in suspected congenital diaphragmatic hernia and renal agenesis.


METHODS
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.
Fetal Medicine Unit, University College Hospital, London, England.
M C
MC
Haeusler
G
G
Ryan
S C
SC
Robson
S
S
Lipitz
C H
CH
Rodeck
D000650:Amnion; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006548:Hernia, Diaphragmatic / Q000000981:diagnostic imaging*; D065630:Hernias, Diaphragmatic, Congenital; D006801:Humans; D007322:Instillation, Drug; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D010537:Peritoneum; D011247:Pregnancy; D012965:Sodium Chloride / Q000008:administration & dosage; D013909:Thorax; D016216:Ultrasonography, Prenatal
D003287:Contrast Media; D012965:Sodium Chloride