ContentsSynopsisCodesDifferential Diagnosis & PitfallsReferences
Emergency: requires immediate attention
Oligohydramnios sequence
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Other Resources UpToDate PubMed
Emergency: requires immediate attention

Oligohydramnios sequence

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Contributors: David Sullo MD, Eric Ingerowski MD, FAAP
Other Resources UpToDate PubMed

Synopsis

Congenital abnormality caused by renal failure in the fetus or from premature rupture of membranes leading to decreased maternal amniotic fluid. This results in internal compression of the fetus causing lung and limb abnormalities. It also results in the characteristic Potter facies (recessed chin, flattened nose, low-set ears, and epicanthal folds). Other signs and symptoms include anuria, pneumothorax, and pulmonary hypoplasia. Causes include polycystic kidney disease and bilateral renal agenesis. In the mother, may be associated with diabetes mellitus and some drugs used during pregnancy.

This is a serious, life-threatening condition, often leading to death of the infant from respiratory failure due to pulmonary hypoplasia or cord compression. Prenatal death or spontaneous abortion may occur during any stage of the pregnancy.

Management depends on gestational stage, cause of oligohydramnios, and extent of fetal complications. In idiopathic cases, low amniotic fluid might improve slightly with maternal hydration therapy, antidiuretics, intravenous fluids, or amnioinfusion. Other considerations include counseling parents, close observation, preparing for premature delivery, and managing pregnancy complications. Peritoneal dialysis and eventual renal transplant may offer chances for survival, but this is far from standard therapy.

Codes

ICD10CM:
Q60.6 – Potter's syndrome

SNOMEDCT:
41962002 – Oligohydramnios sequence

Differential Diagnosis & Pitfalls

The diagnosis should be obvious preterm based on the amniotic fluid volume measurements. The differential of the possible underlying causes is discussed above.

References

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Last Updated: 10/31/2016
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Emergency: requires immediate attention
Oligohydramnios sequence
Print 1 Images
Oligohydramnios sequence (Oligohydramnios sequence) : Limb hypoplasia, Nasal bridge wide, Patient appears ill, Presents antenatally or at birth
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