Serial amnioinfusions as a regenerative therapy for pulmonary hypoplasia in fetuses with intrauterine renal failure: rationale, techniques, and ethical considerations.

This article is a comprehensive review of amniotic fluid, its crucial role in fetal development, particularly lung development, and the implications of its deficiency, oligohydramnios. It describes the various causes of fetal renal failure that lead to oligohydramnios, focusing on congenital anomalies of the urinary tract. The text then introduces amnioinfusion, an experimental therapy that involves infusing fluid into the amniotic sac to compensate for the lack of fetal urine production. It details the rationale for this intervention, outlines the different technical approaches employed, and discusses the potential complications and ethical considerations surrounding this experimental therapy. Lastly, the paper summarizes the rationale and design of the RAFT trial, a clinical study that explored the effectiveness and safety of amnioinfusion in the management of early pregnancy renal anhydramnios (EPRA).