20/07/2026
β‘ Master Potter Sequence in Under 60 Seconds
π What is Potter sequence?
Potter sequence results from severe prolonged oligohydramnios, usually due to reduced fetal urine production or urinary tract obstruction. After 16 weeks' gestation, amniotic fluid is produced mainly by fetal urine, so reduced urine leads to oligohydramnios and fetal compression.
π§ POTTER Features:
β’ P β Pulmonary hypoplasia (most common cause of neonatal death)
β’ O β Oligohydramnios (initiating event)
β’ T β Typical facies (flattened nose, low-set ears, recessed chin, epicanthic folds)
β’ T β Twisted limbs/limb deformities (e.g. clubfoot, contractures)
β’ E β Extremity abnormalities due to compression
β’ R β Renal anomaly or urinary tract obstruction (underlying cause)
π¬ Common Causes:
β Bilateral renal agenesis (most classic cause)
β Autosomal recessive polycystic kidney disease (ARPKD)
β Bilateral multicystic dysplastic kidneys
β Posterior urethral valves (male fetus; enlarged bladder Β± bilateral hydronephrosis)
β Severe placental insufficiency (e.g. fetal growth restriction)
β Preterm prelabour rupture of membranes (PPROM)
β Maternal ACE inhibitor or ARB exposure during pregnancy
π― Exam Pearl:
Potter sequence = Severe oligohydramnios β fetal compression + pulmonary hypoplasia.
The underlying cause varies, but pulmonary hypoplasia is the major cause of neonatal mortality.
Credit to MedHome