Premature rupture of the membranes, oligohydramnios and pulmonary hypoplasia.

The clinical and pathological features of oligohydramnios associated with severe pulmonary hypoplasia are described in 10 infants without renal anomalies. In 8 patients the condition was associated with prolonged premature rupture of the membranes at 16 and 36 weeks of gestation in a study of 244 patients (3.3%). Seven of the infants died of respiratory failure within 24 hours of delivery; the other infant survived. In the remaining 2 patients with severe oligohydramnios at term, but unassociated with premature rupture of the membranes, both infants succumbed. Problems with resuscitation should be anticipated in pregnancies complicated by prolonged leakage of amniotic fluid or oligohydramnios, and pulmonary hypoplasia should be recognized as a cause of respiratory distress. Apart from the ultrasonic predelivery confirmation of normal kidneys to exclude Potter's syndrome it is recommended that ultrasonic assessment of thoracic cage volume should be made before delivery.