Do amniotic bands amputate fetal organs?

Fetoscopic Release of Amniotic Band Syndrome: An Update

Amniotic band syndrome is a rare condition. There have been few cases reported of fetoscopic band dissection. The aim of this case series is to report 3 cases of fetoscopic treatment for amniotic band syndrome, including indication for surgery, technical aspects, complications and outcomes. Fetoscopic treatment was performed respectively at 23 ^5/7 , 26 ^5/7 and 18 ^3/7 weeks' gestation. Two procedures were performed with a laser fiber through a single trocar whereas one surgery was performed with scissors. In conclusion, fetoscopic release of the amniotic bands in case of amniotic band syndrome is feasible with encouraging results in order to prevent amputation and dysfunction of the extremities.

Constriction Rings and Congenital Amputations of the Fingers and Toes in a Mild Case of Amniotic Band Syndrome

Amniotic band syndrome (ABS) may result in fetal anomalies that vary in severity from minor to lethal. Although numerous conditions have been grouped with this diagnosis, a subset of this population will have no other intrauterine abnormalities other than isolated defects of the extremities. ABS may present as constriction rings and congenital amputation affecting the limbs and digits. Routine sonographic evaluation of the fetus in the second trimester can identify the major defects associated with ABS. Detailed evaluation of the fetal extremities, including views of the hands and feet, will increase the detection of minor defects.

Integration of three-dimensional ultrasonography in the prenatal diagnosis of amniotic band syndrome: A case report

Amniotic band syndrome is a rare disorder which is thought to be caused by early rupture of the amniotic membrane. The extent of the disease may vary from minor digital amputations to severe lethal anomalies. For many years in routine clinical practice, this syndrome has been diagnosed with two-dimensional ultrasonography. Evolving imaging techniques by means of three-dimensional ultrasonography gives the chance of early and accurate diagnosis of this devastating anomaly. By integrating three-dimensional ultrasonography to the suspected findings diagnosed in the two-dimensional ultrasonography allows us to predict possible outcomes and provides convenience in counselling. Herein we present a case of amniotic band syndrome diagnosed at 19 weeks of gestation with three-dimensional ultrasonography and pregnancy was terminated in the 20th week. Using three-dimensional ultrasonography in certain suspected foetal anomalies may provide the early diagnosis and more accurate knowledge about extent of the disease.

Endoscopic Release of Limb Constriction Rings in utero

Amniotic band syndrome is a sporadic condition that may result in constriction bands, amputation and multiple craniofacial, visceral and body wall defects. It occurs in 1/1,200 to 1/15,000 live births. Most cases present with multiple congenital anomalies that are incompatible with life. A small group of fetuses shows isolated limb constrictions that may cause severe limb dysfunction or limb amputation if left untreated. Successful in utero surgical lyses of constriction rings have been reported. We report a case of constriction amniotic bands involving both legs and compromising blood flow to the distal extremity. The constriction ring was successfully released by a minimally invasive endoscopic surgical technique avoiding severe limb dysfunction or foot amputation.

Clefting, amniotic bands, and polydactyly: A distinct phenotype that supports an intrinsic mechanism for amniotic band sequence

Amniotic band sequence (ABS) is a well-described condition involving a variety of congenital anomalies in association with fibrous bands. However, many cases are associated with birth defects that are not readily explained by the mechanism of fibrous strings entangling body parts and causing disruption of the fetal structures. The most common of these is typical cleft lip and palate (CLP). Here we describe such a case, with typical ABS limb defects and constriction bands, along with CLP, supernumerary left nipple, polydactyly, and a skin papilla. This case is nearly identical to a child previously described by Guion-Almieda and Richieri-Costa [2000] and may, therefore, represent a previously unrecognized syndrome that overlaps with ABS. Furthermore it may be that cases with ABS-like anomalies associated with CLP represent a different condition, possibly caused by mutations in the genes Disorganization, p63, or IRF6.

Ultrasound prenatal diagnosis of a lateral facial cleft (Tessier number 7)

Lateral facial clefting may occur as an isolated phenomenon or in association with other disorders. It may originate from a failed penetration of ectomesenchyme between the developing maxillary and mandibular prominences, but disruptive factors may also occur in a proportion of cases. The frequency of this abnormality is estimated as 1 in 50 000-175 000 live births. We describe a case of isolated symmetrical lateral facial cleft (number 7 according to the Tessier classification) diagnosed prenatally on ultrasound examination at 26 weeks of gestation.

Amniotic band syndrome with significant orofacial clefts and disruptions and distortions of craniofacial structures

Amniotic band syndrome (ABS) is a rare disorder in which bands of mesoderm that emanate from the chorionic side of the amnion and insert on the fetal body can generate a wide variety of disfiguring and disabling malformations. It usually is sporadic, and the incidence is approximately 1 in 15,000 live births, and affected children typically require involvement of several pediatric surgical subspecialties. The authors describe a case of ABS with extensive craniofacial anomalies.

Spontaneous resolution of amniotic bands

The amniotic band syndrome comprises a group of sporadic congenital anomalies characterized by amputations, constriction bands, pseudosyndactylism and multiple craniofacial, visceral and body wall defects. It occurs in approximately 1 in 1200 to 1 in 15 000 live births. Some of the cases present with congenital anomalies that are incompatible with life, but a selected group shows isolated limb constrictions. Repeated sonographic examinations afforded us the opportunity of observing the in utero process of limb strangulation and subsequent spontaneous lysis of an amniotic band attached to a fetal elbow. Surgical fetal therapy with lysis of the constriction ring in utero is an option, but intervention is probably not always warranted. Spontaneous resolution does occur.

A malformed fetus in a rudimentary uterine horn pregnancy

We present a case of a 13-week pregnancy with a malformed fetus in a ruptured, non-communicating rudimentary horn. The patient, a 21-year-old woman with pelvic and right-sided abdominal pain, was admitted to the gynecology clinic of our institution. A ruptured rudimentary horn pregnancy was diagnosed by ultrasonography. The fetus in the gestation sac showed evisceration of the liver and intestines and an absent left femur. There was an amniotic band extending across the body of the fetus. The ruptured horn was excised by laparotomy. The factors associated with rudimentary horn pregnancy and related fetal abnormalities are discussed.

Intra-uterine fetal demise caused by amniotic band syndrome after standard amniocentesis

The amniotic band syndrome represents a prime example of exogenous disruption of an otherwise normal fetal development. It may be a sequel of invasive diagnostic procedures such as amniocentesis or fetal blood sampling. A 38-year-old gravida II, para II delivered a morphologically normal male stillborn at term. The pregnancy history had been unremarkable but for an early 2nd-trimester amniocentesis. Cause of the intra-uterine fetal demise was noted to be an amniotic band constricting the umbilical cord. An amniotic band is a rare but potentially fatal condition which may be induced by, e.g., invasive prenatal procedures. Such bands are not usually diagnosed prenatally; however, selected patients with augmented risk may profit from intensive ultrasound evaluation including Doppler studies.