Amniotic band syndrome in a monochorionic diamniotic twin pregnancy after rupture of the dividing membrane in the early second trimester: A case report

Abstract Background Amniotic band syndrome is a rare phenomenon, but it can result in serious complications. We report herein our experience of amniotic band syndrome in a monochorionic diamniotic twin pregnancy where rupture of the dividing membrane occurred early in the second trimester. Case Presentation A 29-year-old nulliparous woman was referred to us for management of her monochorionic diamniotic twin pregnancy at 10 weeks of gestation. When we were unable to identify a dividing membrane at 15 weeks of gestation using two-dimensional ultrasonography, we used three-dimensional ultrasonography to confirm its absence. Both modalities showed that the left arm of baby B was swollen and attached to a membranous structure originating from the placenta at 18 weeks of gestation. Tangled umbilical cords were noted on magnetic resonance imaging at 18 weeks of gestation. Emergency cesarean delivery was performed at 30 weeks of gestation because of the nonreassuring fetal status of baby A. The left arm of baby B had a constrictive ring with a skin defect. Both neonates had an uncomplicated postnatal course and were discharged around 2 months after delivery. Conclusions Attention should be paid to the potential for amniotic band syndrome if rupture of the dividing membrane between twins is noted during early gestation.

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Case Report: Early Fetoscopic Management of Monochorionic Twin Pregnancy Complicated by Amniotic Band Syndrome and Twin to Twin Transfusion

Ultrasound ◽

10.1179/174313405x27490 ◽

2005 ◽

Vol 13 (1) ◽

pp. 54-56

Author(s):

Van C. Holsbeke ◽

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Keyword(s):

Skin Lesion ◽

Twin Pregnancy ◽

Complex Case ◽

Second Trimester ◽

Bipolar Coagulation ◽

Amniotic Band ◽

Healthy Baby ◽

Monochorionic Twin ◽

Amniotic Band Syndrome ◽

Aplasia Cutis

We report a case where discordant amniotic band syndrome was diagnosed in a monochorionic twin pregnancy in the early second trimester of pregnancy. Pregnancy was also complicated by twin-to-twin transfusion syndrome. Therapeutic options were limited because of the severity of the amniotic strings and the twin transfusion syndrome. We offered selective feticide by bipolar coagulation of the umbilical cord of the affected fetus. This was performed successfully and also converted the transfusion syndrome, leading to the term birth of a healthy baby, with an 'aplasia cutis'-like skin lesion on the skull. The differential diagnostic and therapeutic steps in this complex case are discussed, as well as the possible relationship between the skin lesion and the fetoscopic intervention.

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Amniotic band syndrome in second trimester associated with fetal malformations

Prenatal Diagnosis ◽

10.1002/pd.1970040412 ◽

1984 ◽

Vol 4 (4) ◽

pp. 311-314 ◽

Cited By ~ 5

Author(s):

Karl-Gerhardt Børlum

Keyword(s):

Second Trimester ◽

Amniotic Band ◽

Amniotic Band Syndrome ◽

Fetal Malformations

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Further insights into unusual acrania-exencephaly-anencephaly sequence caused by amniotic band – first trimester fetoscopic correlation with two- and three-dimensional ultrasound

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2021-0023 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Jan Weichert ◽

Waldo Sepulveda ◽

Michael Gembicki

Keyword(s):

Neural Tube Defect ◽

Three Dimensional ◽

First Trimester ◽

Cystic Degeneration ◽

Amniotic Band ◽

Case Presentation ◽

Constriction Ring ◽

Antenatal Detection ◽

Unusual Type

Abstract Objectives Antenatal detection of acrania-exencephaly-anencephaly (AEA) sequence beyond 10 completed weeks of gestation is usually straight-forward. An earlier detection and classification of the causative conditions prior to disaggregation of exposed dysplastic brain tissue remains challenging. Case presentation We present two- and three-dimensional ultrasound correlated with fetoscopic findings of an unusual type of neural tube defect at 11 gestational weeks caused by an amniotic constriction ring resulting in cystic degeneration of the developing skull. Conclusions By giving further illustrative insights into early defective brain development, this report confirms recent findings of an unusual subtype of acrania-exencephaly-anencephaly sequence suggesting early disruption of the developing brain, following an amniotic entrapment of the skull.

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A case of amniotic band syndrome associated with anencephaly demonstrated using three-dimensional ultrasound at early pregnancy

Korean Journal of Obstetrics & Gynecology ◽

10.5468/kjog.2011.54.3.155 ◽

2011 ◽

Vol 54 (3) ◽

pp. 155

Author(s):

Hyun Jin Cho ◽

Yeon Mee Kim ◽

Gyun-ho Jeon ◽

Sungwook Chun ◽

Chul-hoi Jeong ◽

...

Keyword(s):

Early Pregnancy ◽

Three Dimensional ◽

Amniotic Band ◽

Amniotic Band Syndrome

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Spontaneous Septostomy in a Twin Pregnancy Causing Fatal Amniotic Band Syndrome

Case Reports in Pediatrics ◽

10.1155/2018/4549060 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3

Author(s):

Carolina Hvelplund ◽

Kasper Pihl ◽

Simon Trautner ◽

Pernille Pedersen ◽

Lisa Leth Maroun

Keyword(s):

Twin Pregnancy ◽

Distress Syndrome ◽

Broad Band ◽

Lung Hypoplasia ◽

Lower Abdomen ◽

Bilateral Pneumothorax ◽

Amniotic Band ◽

Twin Sister ◽

Amniotic Band Syndrome ◽

Severe Lung

Complications due to spontaneous septostomy of the dividing membrane in monochorionic diamniotic pregnancies are rarely described. Herein, we report the case of a preterm female neonate from a monochorionic diamniotic twin pregnancy delivered by caesarean section at 32 weeks of gestation. She was born with a broad band of a transparent membrane-like material firmly attached to her lower abdomen. Postnatally, she developed respiratory distress syndrome and persistent pulmonary hypertension, complicated by bilateral pneumothorax. She died due to respiratory failure when she was 1 day old. Her twin sister survived with no malformations. At postmortem examination, the neonate had severe lung hypoplasia, and the attached material was diagnosed as the dividing septum. We hypothesize that the lung hypoplasia was secondary to local oligohydramnios, which developed as a consequence of the twin being firmly stuck in the defect of the dividing membrane. To our best knowledge, spontaneous septostomy causing an ultimately fatal amniotic band syndrome has not previously been described.

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A Neonate with Amniotic Band Syndrome and Osteomyelitis

10.21203/rs.3.rs-80180/v1 ◽

2020 ◽

Author(s):

Nazanin Zafaranloo ◽

Fereshteh Moshfegh ◽

Parisa Mohagheghi ◽

Babak Beigi ◽

Elahe Nourozi

Keyword(s):

Congenital Malformations ◽

Chronic Osteomyelitis ◽

Amniotic Band ◽

Case Presentation ◽

Live Births ◽

Amniotic Band Syndrome ◽

Interprofessional Teamwork ◽

Males And Females ◽

Anatomic Region

Abstract Background: Amniotic band syndrome (ABS) comprises of a spectrum of congenital malformations involving the limbs more often, but any other anatomic region of fetus could be involved (1). Its prevalence has been reported to range from 0.19 to 8.1 per 10000 live births (2). There are different theories for explaining the etiology of amniotic bands, but it has been considered to have a multifactorial etiology. (2) Fetoscopic release of amniotic bands affecting one or more extremities can prevent limb loss or preserve limb function when distal fellow is still identifiable on preoperative ultrasound scans (3)(4). ABS occurs in 77% of fetuses with multiple anomalies (5). Both males and females are equally affected (6). Osteomyelitis in neonates is relatively uncommon, but burdened with an increased hospital stay and possible long‐term sequela if not diagnosed on time (18). The long bones are the most frequently affected sites (18).Case presentation: Here we are introducing a neonate with left upper extremity necrosis due to ABS which needed amputation and it was associated with severe chronic osteomyelitis.Conclusion: Amniotic band syndrome mostly involves the limbs. It is important to diagnose it as soon as possible, because with the interprofessional teamwork approach, an optimal patient result with fetoscopic or surgery procedures could be achieved.

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Infrequent association of two rare diseases: amniotic band syndrome and osteogenesis imperfecta

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2021-0035 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Savaş Mert Darakci ◽

Sabahattin Ertuğrul ◽

Sibel Tanrıverdi Yılmaz ◽

Edip Ünal ◽

İlyas Yolbaş ◽

...

Keyword(s):

Osteogenesis Imperfecta ◽

Upper Extremities ◽

Structural Defects ◽

Newborn Period ◽

Amniotic Band ◽

Case Presentation ◽

Amniotic Band Syndrome ◽

Collagen Protein ◽

Gestational Week ◽

Collagen Tissue

Abstract Objectives Amniotic band syndrome and osteogenesis imperfecta are two distinct diseases that develop due to structural defects of the collagen protein. In our paper, we report the concurrence of these two diseases rarely seen in the newborn period. Case presentation A female infant born at 33rd gestational week was found to have constrictive bands in her right lower extremity and flexion contractures in distal joints of lower and upper extremities due to amniotic bands in postnatal physical examination. While being treated for respiratory difficulty, she was diagnosed with osteogenesis imperfecta and treated with bisphosphonates upon being found to suffer bilateral humeral fractures on the sixth day of life. She received respiratory support with mechanical ventilation due to respiratory tract complications related to osteogenesis imperfecta and died on the 384th day of life. Conclusions One should bear in mind that other collagen tissue diseases may accompany the amniotic band syndrome; this possibility should be definitely pursued if clinical suspicion exists.

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