Have you ever encountered this?

prmenrs, RN · May 20, 2006

http://www.emedicine.com/PED/topic1878.htm

EricJRN, MSN, RN · May 21, 2006

Studied it, but have yet to see one just yet.

judyblueeyes · May 22, 2006

I've seen alot of Potters Facies, mostly due to PROM. Some syndromes- outcome dependent on the fetal dx.

Jolie, BSN · May 22, 2006

I cared for an infant born with Potter's Syndrome about 18 years ago. The parents knew of the diagnosis prenatally, consulted with pediatric surgeons and neonatologists, and made arrangements for the baby to be delivered at a facility with pediatric surgery and ECMO capabilities. At the time of delivery however, all of that facility's ECMO beds were full, so a transer was made to our unit, which would have not ordinarily accepted an infant with this diagnosis for ECMO.

The plan was for ECMO in the hopes of supporting the baby's respiratory status while allowing his underdeveloped lungs to mature, and dialysis while awaiting a kidney transplant. The baby was weaned after a lengthy ECMO run and progressed to a nasal cannula. He received peritoneal dialysis throughout his stay. I can still picture his chubby face as he nippled a bottle of formula the day before he began to decline. His lungs simply couldn't support him for long, and he died in the unit.

I had mixed feelings about his care. He endured numerous painful procedures in his short life, to enjoy roughly one day of "good health". I don't know if what we did was right or wrong. It allowed his parents to know their baby, and may have advanced the treatment of this syndrome for future infants and parents, but it seemed a steep price for the precious little boy to pay.

I don't know the current state of treatment for infants born with Potter's Syndrome, and offer my prayers to anyone facing it.

babynurselsa, RN · May 22, 2006

I have only seen a few. The first was a known Potters syndrome. We attended the delivery but did not perform interventions. This baby passed shortly after delivery in mom's arms.

Another was one of those "we don't see kidneys on the u/s and we aren't sure we see x and y and z...." This baby was intubated at delivery but declined rapidly and passed within a few days.

The last one was not dx was aggresively resusitated but passed within a couple of hours.

mad9 · May 22, 2006

I cared for an infant born with Potter's Syndrome about 18 years ago. The parents knew of the diagnosis prenatally, consulted with pediatric surgeons and neonatologists, and made arrangements for the baby to be delivered at a facility with pediatric surgery and ECMO capabilities. At the time of delivery however, all of that facility's ECMO beds were full, so a transer was made to our unit, which would have not ordinarily accepted an infant with this diagnosis for ECMO.
The plan was for ECMO in the hopes of supporting the baby's respiratory status while allowing his underdeveloped lungs to mature, and dialysis while awaiting a kidney transplant. The baby was weaned after a lengthy ECMO run and progressed to a nasal cannula. He received peritoneal dialysis throughout his stay. I can still picture his chubby face as he nippled a bottle of formula the day before he began to decline. His lungs simply couldn't support him for long, and he died in the unit.
I had mixed feelings about his care. He endured numerous painful procedures in his short life, to enjoy roughly one day of "good health". I don't know if what we did was right or wrong. It allowed his parents to know their baby, and may have advanced the treatment of this syndrome for future infants and parents, but it seemed a steep price for the precious little boy to pay.
I don't know the current state of treatment for infants born with Potter's Syndrome, and offer my prayers to anyone facing it.

Thank you Jolie for your response to my question. You have helped me more than you know.

The anniversary of my baby boy's birthday and passing will be on May 23. He died the same day he was born from Potter's Syndrome.

I wrote a detailed post about my experience but had to delete it because even today it is still very painful and I didn't feel comfortable sharing it. (A little too late after posting it, huh?)

It may sound strange to you but it comforts me that you remember the baby you helped care for.

I still feel that they did my child and me a disservice by attempting to resuscitate him when they knew full well what the outcome would be.

I only got to hold him after he passed, that has been the hardest.

I don't know what they could have done to make his passing easier.

He lived for 15 minutes after birth.

Thank you for taking the time to reply, I do appreciate it.

RunnerRN, BSN, RN · May 22, 2006

I'm an ER nurse who has obviously never encountered this, I don't even remember learning about it in school. I read the above link, but haven't had my AM coffee yet and need someone to dumb it down for me. The basics I gleaned were that the mother doesn't produce enough amniotic fluid, and the end result is Potter's Sx. Is this something that is simply related to the oligohydramnios, or is there a congenital defect in place as well?

Thanks!

Jolie, BSN · May 22, 2006

Thank you Jolie for your response to my question. You have helped me more than you know.
The anniversary of my baby boy's birthday and passing will be on May 23. He died the same day he was born from Potter's Syndrome.
I wrote a detailed post about my experience but had to delete it because even today it is still very painful and I didn't feel comfortable sharing it. (A little too late after posting it, huh?)
It may sound strange to you but it comforts me that you remember the baby you helped care for.
I still feel that they did my child and me a disservice by attempting to resuscitate him when they knew full well what the outcome would be.
I only got to hold him after he passed, that has been the hardest.
I don't know what they could have done to make his passing easier.
He lived for 15 minutes after birth.
Thank you for taking the time to reply, I do appreciate it.

My prayers to you and your family.

I've cared for thousands of babies in my career, some long-term, whom I remember well, and some who have faded from my memory with time.

But I am quite certain that I remember every baby who died in my care. They are the precious souls who touch me the most, as they remind me that some lives are so fragile that they can be made whole only in Heaven. Rest assured that your doctors and nurses remember you and your baby vividly. He touched more lives than you will ever know.

Please accept my wishes of a peaceful day tomorow as you celebrate your son. May God guide you gently toward the day when you will be able to remember him with a smile, and not a tear.

Jolie, BSN · May 22, 2006

I'm an ER nurse who has obviously never encountered this, I don't even remember learning about it in school. I read the above link, but haven't had my AM coffee yet and need someone to dumb it down for me. The basics I gleaned were that the mother doesn't produce enough amniotic fluid, and the end result is Potter's Sx. Is this something that is simply related to the oligohydramnios, or is there a congenital defect in place as well?
Thanks!

Potter's Syndrome is a congenital condition that is characterized by hypoplastic lungs and renal agenesis, among other abnormalities. To my knowledge, it is fatal.

EricJRN, MSN, RN · May 22, 2006

I'm an ER nurse who has obviously never encountered this, I don't even remember learning about it in school. I read the above link, but haven't had my AM coffee yet and need someone to dumb it down for me. The basics I gleaned were that the mother doesn't produce enough amniotic fluid, and the end result is Potter's Sx. Is this something that is simply related to the oligohydramnios, or is there a congenital defect in place as well?
Thanks!

Amniotic fluid is composed largely of fetal urine, so if the baby has no kidneys (renal agenesis), it will have significantly less amniotic fluid (oligohydramnios). Oligohydramnios is responsible for facial changes, but ultimately the fact that the baby has no kidneys is what usually makes for the very poor prognosis.

Jolie, BSN · May 22, 2006

Amniotic fluid is composed largely of fetal urine, so if the baby has no kidneys (renal agenesis), it will have significantly less amniotic fluid (oligohydramnios). Oligohydramnios is responsible for facial changes, but ultimately the fact that the baby has no kidneys is what usually makes for the very poor prognosis.

Oligohydramnios is also responsible for the insufficient development of the fetal lungs. Most babies with Potter's Syndrome die of respiratory failure due to hypoplastic lungs, even before renal failure becomes an issue.