Potter sequence


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Potter sequence

Reproductive system

Male and female reproductive system disorders

Precocious puberty

Delayed puberty

Klinefelter syndrome

Turner syndrome

Androgen insensitivity syndrome

5-alpha-reductase deficiency

Kallmann syndrome

Male reproductive system disorders

Hypospadias and epispadias

Bladder exstrophy


Penile cancer


Benign prostatic hyperplasia

Prostate cancer


Inguinal hernia




Testicular torsion

Testicular cancer

Erectile dysfunction

Male hypoactive sexual desire disorder

Female reproductive system disorders


Ovarian cyst

Premature ovarian failure

Polycystic ovary syndrome

Ovarian torsion

Krukenberg tumor

Sex cord-gonadal stromal tumor

Surface epithelial-stromal tumor

Germ cell ovarian tumor

Uterine fibroid



Endometrial hyperplasia

Endometrial cancer


Cervical cancer

Pelvic inflammatory disease


Female sexual interest and arousal disorder

Orgasmic dysfunction

Genito-pelvic pain and penetration disorder


Fibrocystic breast changes

Intraductal papilloma

Phyllodes tumor

Paget disease of the breast

Breast cancer

Hyperemesis gravidarum

Gestational hypertension

Preeclampsia & eclampsia

Gestational diabetes

Cervical incompetence

Placenta previa

Placenta accreta

Placental abruption



Potter sequence

Intrauterine growth restriction

Preterm labor

Postpartum hemorrhage


Congenital toxoplasmosis

Congenital cytomegalovirus (NORD)

Congenital syphilis

Neonatal conjunctivitis

Neonatal herpes simplex

Congenital rubella syndrome

Neonatal sepsis

Neonatal meningitis


Gestational trophoblastic disease

Ectopic pregnancy

Fetal hydantoin syndrome

Fetal alcohol syndrome

Reproductive system pathology review

Disorders of sex chromosomes: Pathology review

Prostate disorders and cancer: Pathology review

Testicular tumors: Pathology review

Uterine disorders: Pathology review

Ovarian cysts and tumors: Pathology review

Cervical cancer: Pathology review

Vaginal and vulvar disorders: Pathology review

Benign breast conditions: Pathology review

Breast cancer: Pathology review

Complications during pregnancy: Pathology review

Congenital TORCH infections: Pathology review

Disorders of sexual development and sex hormones: Pathology review

Amenorrhea: Pathology Review

Testicular and scrotal conditions: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

HIV and AIDS: Pathology review

Penile conditions: Pathology review


Potter sequence


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USMLE® Step 1 questions

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Potter sequence

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USMLE® Step 1 style questions USMLE

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A 24-year-old gravida 1 para 0 woman at 27 weeks of gestation comes to the office for evaluation of a low amniotic fluid index discovered on a biophysical profile. The pregnancy has been complicated by gestational diabetes mellitus. The patient is currently on an insulin regimen. Fetal ultrasonography shows bilateral absence of the kidneys. The doctor explains to the mother that this is most likely due to aberrant interaction between the ureteric bud and metanephric mesenchyme. Which of the following structures does the ureteric bud give rise to under normal conditions?  

External References

First Aid


Potter sequence p. 548

External Links


Content Reviewers

Rishi Desai, MD, MPH


Tanner Marshall, MS

Potter sequence is a rare disorder that is sometimes called oligohydramnios sequence—a term that helps define it because oligo- means low and -hydramnios means amniotic fluid.

So in Potter sequence there’s basically very little amniotic fluid and this makes the uterus a pretty hostile place for the fetus to grow.

Typically, around the 20th week of gestation, the kidneys, ureters, and urethra develop and start producing and excreting urine, and this urine becomes the major source of amniotic fluid.

Various conditions like renal agenesis, which is when one or both kidneys are missing, or atresia of the ureter or urethra, which is where those parts of the urinary tract are obstructed, can lead to an inability to produce or excrete urine and therefore leads to oligohydramnios.

Other common causes can include amniotic rupture, which is the leakage of amniotic fluid, or uteroplacental insufficiency, which is where there’s low blood flow from the placenta meaning the fetal organs—which includes the fetal kidneys—see less blood flow, which in turn leads to decreased urine production.

When there’s very little amniotic fluid, a couple of things happen as a result. First, amniotic fluid is crucial for the development of the fetal lungs, by both helping the airways physically stretch out as well as contributing amino acids like proline, which helps with the formation of connective tissue and collagen in the lung.

With less amniotic fluid, though, there’s pulmonary hypoplasia. Hypo meaning under, and -plasia means formation, so the lungs basically remain underdeveloped.

Not only that though, with less amniotic fluid, there’s less space in the amniotic sac, and so the fetus is literally compressed into a smaller space, which causes developmental abnormalities like a flattened face, wrinkly skin, widely separated eyes with epicanthal folds, low-set ears, as well as limb abnormalities like clubbed feet.


Potter sequence is the atypical physical appearance of a fetus or neonate resulting from oligohydramnios experienced in the uterus. POTTER itself is a mnemonic, and it stands for Pulmonary hypoplasia, Oligohydramnios, Twisted skin for wrinkles, Twisted face, Extremity deformities, and Renal agenesis.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Potter′s sequence" Journal of Clinical Neonatology (2012)
  6. "Special Imaging Casebook" Journal of Perinatology (2000)
  7. "The Potter Syndrome of Renal Agenesis" BMJ (1958)

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