Review Question - QID 101903

Bilateral multicystic dysplatic kidneys are seen in Potter's syndrome, in which clubbed feet is also common.

Bilateral renal agenesis is the most common cause of oligohydramnios (deficiency of amniotic fluid) and can result from conditions such as bilateral multicystic dysplastic kidney or a genetic disorder leading to malformation of the ureteric bud. Many different structures are involved in Potter's syndrome including the limbs (clubbed feet), face (suborbital creases, depressed nasal tip, low-set ears, retrognathia), and lungs (pulmonary hypoplasia). Potter's syndrome can be fatal shortly after birth due to pulmonary hypoplasia and subsequent respiratory failure.

Illustration A shows bilateral clubfoot abnormality (congenital talipes equinovarus). Illustration B shows a whole-body image of a Potter's sequence infant.

Incorrect Answers:
Answer 1: A urachal fistula is an open communication between the bladder and the umbilicus; it results from the persistence of the lumen of the intraembryonic portion of the allantois.
Answer 2: Esophageal atresia typically presents as a blind ending of the upper esophagus with an aberrant connection between the lower esophagus and trachea; it is associated with polyhydramnios in the 3rd trimester and is a component of the VACTERL association (Vertebral defects, Anorectal, Cardiac, Tracheal, Esophageal, Renal, & Limbs).
Answer 3: Spina bifida occulta is a relatively minor neural tube defect with no herniation of contents through the failed closure of the bony spinal canal. NTDs are associated with low folic acid intake during pregnancy.
Answer 5: Macrosomia is excessive birth weight; associated with maternal or gestational diabetes.