Potter Sequence-role of perinatal autopsy in diagnosis

Congenital malformations of kidney and urinary tract in the fetus are one of the commonest causes for development of oligohydramnios in antenatal life. Oligohydramnios, present over a prolonged period of time can result in compression deformities of the fetus that have been collectively termed as potter sequence. A retrospective study of 24 perinatal autopsies presenting with a history of oligohydramnios was done to evaluate the relative frequencies of congenital malformations and their association with potter sequence. We observed that 8 out of 12 cases of potter sequence were having an underlying congenital anomaly of kidney and urinary tract, whereas in the rest 4 cases of potter sequence the pathogenesis of oligohydramnios can be attributed to non renal causes. We also observed 4 cases of congenital malformations of kidneys that were not severe enough to produce potter sequence. We recommend that a meticulously done perinatal autopsy, in the light of thorough clinical and ultrasonological findings can yield a wealth of information regarding precise diagnosis of congenital malformations.