Elective Cesarean Section during Preterm Prevents Pulmonary Hypoplasia Development in Potter Sequence

Area of Science:

• Perinatology
• Neonatology
• Pediatric Nephrology

Background:

• Potter syndrome, characterized by bilateral renal aplasia, leads to oligohydramnios, pulmonary hypoplasia, and distinctive facial and limb anomalies.
• Potter sequence encompasses similar manifestations but arises from various causes of oligohydramnios, presenting diagnostic and management challenges.
• Current guidelines for optimal delivery timing and postpartum care in Potter sequence are limited.

Observation:

• A case of Potter sequence was managed, involving a fetus with oligohydramnios, unilateral kidney agenesis, and contralateral multicystic dysplastic kidney.
• Prenatal imaging revealed significant pulmonary hypoplasia, with a low fetal lung volume to body weight ratio.
• The fetus experienced persistent oligohydramnios, suspected to impede lung growth.

Findings:

• Elective cesarean delivery was performed at 34 weeks gestation.
• Postnatal management included intensive respiratory support, dialysis, and nutritional therapy.
• The infant survived and was discharged at 169 days of age.

Implications:

• Early elective cesarean delivery in premature births complicated by Potter sequence may mitigate pulmonary hypoplasia progression.
• Aggressive multidisciplinary postpartum management is crucial for stabilizing affected infants.
• Further research is essential to establish evidence-based protocols for Potter sequence management and improve outcomes.