Limb deformations in oligohydramnios sequence: Effects of gestational age and duration of oligohydramnios

In order to study the pathogenesis of prenatal deformities, we reviewed mat ernal histories, delivery records, pathology reports, radiographs, and phot ographs of 90 fetuses with prenatally documented oligohydramnios at gestati onal ages from 14 weeks to term, The causes of oligohydramnios. included pr emature rupture of membranes (44 cases), fetal renal insufficiency (25 case s), idiopathic (15 cases), and twin-twin transfusion (6 cases), The fetuses were grouped according to gestational age at delivery and duration of olig ohydramnios. Sixty-three fetuses (70%) had documented contractures, As expe cted, contractures were more frequent with earlier onset and longer duratio n of oligohydramnios. During the 2nd trimester, the frequency of contractur es in fetuses with oligohydramnios was 77% compared to 52% in the 3rd trime ster (chi(2) = 5.33, 1 df, P = .02), Considering all gestational ages toget her, 57% of fetuses had contractures after less than 2 weeks of oligohydram nios compared to 81% of fetuses with a longer duration of oligohydramnios ( (chi(2) = 6.23, 1 df, P < .02). The type of contracture varied with gestati onal age. Clubfoot was the most frequent at all ages, but hand contractures such as camptodactyly were common only in the 2nd trimester while the broa d flat hand originally described in Potter sequence was found almost exclus ively in the fetuses with oligohydramnios in the 3rd trimester, Of the 63 f etuses with oligohydramnios and contractures, 25 (40%) had either additiona l malformations or family history that could explain contractures independe nt of oligohydramnios. (C) 1999 Wiley-Liss, Inc.