Potter syndrome

Definition

Potter syndrome and Potter phenotype is a complex of findings associated with a lack of amniotic fluid and with kidney failure that develops before an infant is born .

Causes

In Potter syndrome the primary defect is kidney failure that occurs before the baby is born, either from failure of the kidneys to develop (bilateral renal agenesis), or from other diseases that cause the kidneys to fail. The kidneys normally produce the amniotic fluid (as urine).

Potter phenotype describes a typical appearance that, in the newborn, is determined by the absence of amniotic fluid (oligohydramnios). In the absence of amniotic fluid, the infant is not cushioned from the walls of the uterus. The pressure of the uterine wall causes a typical facial appearance (Potter's facies) that includes widely separated eyes with epicanthal folds, broad nasal bridge, low set ears and receding chin.

In addition, because of limited space in the uterus, the limbs may be abnormal, or held in abnormal positions or contractures. Oligohydramnios also stops development of the lungs (hypoplastic lungs), so that at birth the lungs do not function properly.

Symptoms

• Potter facies (described above)
• Absence of urine output
• Difficulty breathing

Exams and Tests

Signs include:

• Stiff lungs during resuscitation effort, requiring high pressure for ventilation
• Absence of amniotic fluid
• Urogenital abnormalities

• Fetal ultrasound (of mother before birth) -- may show lack of amniotic fluid, absence of fetal kidneys, or severely abnormal kidneys
• X-ray of the abdomen (of newborn)
• X-ray of the lungs (of newborn)
• Blood gases

Treatment

Resuscitation at delivery may be attempted pending the diagnosis. Treatment will be provided for any urinary outlet obstruction.

Outlook (Prognosis)

This is a fatal condition. Bilateral renal agenesis and hypoplastic lungs are incompatible with life.

Prevention

There is no known prevention.

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