1
|
Goel A, Goel A. Optimal timing for plastic surgical procedures for common congenital anomalies: A review. World J Clin Pediatr 2024; 13:90583. [PMID: 38947997 PMCID: PMC11212758 DOI: 10.5409/wjcp.v13.i2.90583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/04/2024] [Accepted: 04/11/2024] [Indexed: 06/07/2024] Open
Abstract
Apart from listening to the cry of a healthy newborn, it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents. The global incidence of children born with congenital anomalies has been reported to be 3%-6% with more than 90% of these occurring in low- and middle-income group countries. The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons. These children are operated under several surgical disciplines, viz, paediatric-, plastic reconstructive, neuro-, cardiothoracic-, orthopaedic surgery etc. These conditions may be life-threatening, e.g., trachea-oesophageal fistula, critical pulmonary stenosis, etc. and require immediate surgical intervention. Some, e.g., hydrocephalus, may need intervention as soon as the patient is fit for surgery. Some, e.g., patent ductus arteriosus need 'wait and watch' policy up to a certain age in the hope of spontaneous recovery. Another extremely important category is that of patients where the operative intervention is done based on their age. Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery (many as multiple stages of correction) at appropriate ages. There are advantages and disadvantages of intervention at different ages. In this article, we present a review of optimal timings, along with reasoning, for surgery of many of the common congenital anomalies which are treated by plastic surgeons. Obstetricians, paediatricians and general practitioners/family physicians, who most often are the first ones to come across such children, must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.
Collapse
Affiliation(s)
| | - Arun Goel
- Department of Plastic Surgery, Lok Nayak Hospital and Associated Maulana Azad Medical College, New Delhi 110002, India
| |
Collapse
|
2
|
Doğru Ş, Acar A. Fetoscopic surgery for amniotic band syndrome: Case series. Congenit Anom (Kyoto) 2023; 63:4-8. [PMID: 36116114 DOI: 10.1111/cga.12494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/09/2022] [Accepted: 09/03/2022] [Indexed: 01/05/2023]
Abstract
We aimed to evaluate the fetoscopic procedure indications, procedure-related complications, and neonatal outcomes in cases diagnosed with amniotic band syndrome (ABS). Stage II and III cases according to Hüsler classification were included for fetoscopic surgery. Scissors were used to release the amniotic band in six cases, and a diode laser was used in one case. A single entry was made in all cases. The majority of the children acquired a functional limb (71.4%). Fetal morbidity was mainly linked to the consequences of preterm premature rupture of the membranes (57.1%) and preterm birth (28.5%). Excluding complicated cases, fetoscopic band release is encouraging in cases of ABS in the limbs.
Collapse
Affiliation(s)
- Şükran Doğru
- Division of Maternal and Fetal Medicine, Necmettin Erbakan University (NEU) Meram Faculty of Medicine, Konya, Turkey
| | - Ali Acar
- Division of Maternal and Fetal Medicine, Necmettin Erbakan University (NEU) Meram Faculty of Medicine, Konya, Turkey
| |
Collapse
|
3
|
Bailleul A, Athiel Y, Gueneuc A, Salomon L. Ultrasound findings in Pseudoamniotic band syndrome after fetoscopic surgery: Antenatal description of three cases and review of literature. J Gynecol Obstet Hum Reprod 2021; 50:102178. [PMID: 34107358 DOI: 10.1016/j.jogoh.2021.102178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/20/2021] [Accepted: 06/01/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pseudoamniotic Bands Syndrome (PABS) was described as iatrogenic complication from in utero procedure as fetoscopy. OBJECTIVE The aim of our study was to identify the ultrasound findings in PABS diagnosed prenatally METHODS: First, we reported cases of PABS following fetoscopic surgery that were diagnosed prenatally in our institution. We collected all ultrasound data with fetal and neonatal issues. Then, a literature review was conducted by searching the Medline and Cochrane Library computer databases until 2020 to find publications that involve PABS diagnosed prenatally or postnatally. The following keywords were selected and combined: "pseudoamniotic bands syndrome", "fetoscopy", "fetal surgery". RESULTS We collected three cases of PABS diagnosed prenatally in our center following fetoscopic procedures for complicated monochorionic pregnancies. Among these cases, we reported the following ultrasound findings: floating membrane, amniotic bands, striction of limbs, perilesional edema, reduced member size and anomalies of Doppler flow. Including our cases, we reported 23 published PABS of which eight (35%) were prenatally diagnosed. When it was diagnosed, mean GA at PABS diagnosis was 23 weeks (mean interval from fetoscopic to diagnosis was 4 weeks). Three fetoscopic release of amniotic bands were described. The principal parts affected were the limbs, more particularly the extremities. CONCLUSION PABS was accessible to an antenatal diagnosis, as well as ABS. Although it is a rare complication of fetoscopic surgery, ultrasound examinations after procedure should focus on PABS signs to improve prognosis of the neonates.
Collapse
Affiliation(s)
- Alexandre Bailleul
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Yoann Athiel
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Alexandra Gueneuc
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| | - Laurent Salomon
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France; National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| |
Collapse
|
4
|
Minella C, Costantino B, Ruano R, Koch A, Weingertner AS, Favre R, Sananes N. Fetoscopic Release of Amniotic Band Syndrome: An Update. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:1039-1048. [PMID: 32951245 DOI: 10.1002/jum.15480] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/17/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
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.
Collapse
Affiliation(s)
- Chris Minella
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
| | | | - Rodrigo Ruano
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Antoine Koch
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
| | | | - Romain Favre
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
| | - Nicolas Sananes
- Department of Maternal Fetal Medicine, Strasbourg University Hospital, France
- INSERM, UMR-S 1121, "Biomatériaux et Bioingénierie", Strasbourg University, France
| |
Collapse
|
5
|
Sharma D, Tsibizova VI. Current perspective and scope of fetal therapy: part 1. J Matern Fetal Neonatal Med 2020; 35:3783-3811. [PMID: 33135508 DOI: 10.1080/14767058.2020.1839880] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Fetal therapy term has been described for any therapeutic intervention either invasive or noninvasive for the purpose of correcting or treating any fetal malformation or condition. Fetal therapy is a rapidly evolving specialty and has gained pace in last two decades and now fetal intervention is being tried in many malformations with rate of success varying with the type of different fetal conditions. The advances in imaging techniques have allowed fetal medicine persons to make earlier and accurate diagnosis of numerous fetal anomalies. Still many fetal anomalies are managed postnatally because the fetal outcomes have not changed significantly with the use of fetal therapy and this approach avoids unnecessary maternal risk secondary to inutero intervention. The short-term maternal risk associated with fetal surgery includes preterm labor, premature rupture of membranes, uterine wall bleeding, chorioamniotic separation, placental abruption, chorioamnionitis, and anesthesia risk. Whereas, maternal long-term complications include risk of infertility, uterine rupture, and need for cesarean section in future pregnancies. The decision for invasive fetal therapy should be taken after discussion with parents about the various aspects like postnatal fetal outcome without fetal intervention, possible outcome if the fetal intervention is done, available postnatal intervention for the fetal condition, and possible short-term and long-term maternal complications. The center where fetal intervention is done should have facility of multi-disciplinary team to manage both maternal and fetal complications. The major issues in the development of fetal surgery include selection of patient for intervention, crafting effective fetal surgical skills, requirement of regular fetal and uterine monitoring, effective tocolysis, and minimizing fetal and maternal fetal risks. This review will cover the surgical or invasive aspect of fetal therapy with available evidence and will highlight the progress made in the management of fetal malformations in last two decades.
Collapse
Affiliation(s)
- Deepak Sharma
- Department of Neonatology, National Institute of Medical Science, Jaipur, India
| | - Valentina I Tsibizova
- Almazov National Medical Research Centre, Health Ministry of Russian Federation, Saint Petersburg, Russia
| |
Collapse
|
6
|
Abstract
Advances in imaging and technique have pushed the boundaries of the types of surgical interventions available to fetuses with congenital and developmental abnormalities. This review focuses on fundamental aspects of fetal anesthesia, including the physiologic changes of pregnancy, uteroplacental perfusion, and fetal physiology. We discuss the types of fetal surgeries and procedures currently being performed and discuss the specific anesthetic approaches to different categories of fetal surgeries. We also discuss ethical aspects of fetal surgery and anesthesia.
Collapse
|
7
|
Gueneuc A, Chalouhi GE, Borali D, Mediouni I, Stirnemann J, Ville Y. Fetoscopic Release of Amniotic Bands Causing Limb Constriction: Case Series and Review of the Literature. Fetal Diagn Ther 2019; 46:246-256. [PMID: 30726851 DOI: 10.1159/000495505] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/14/2018] [Indexed: 11/19/2022]
Abstract
The aim of this study was to review the perioperative complication rates and neonatal outcomes after fetoscopic release of amniotic bands that caused bilateral limb constrictions. We present 5 cases of limb constriction by amniotic bands occurring spontaneously or following fetoscopic surgery and also include a review of 21 previously published cases. The cases were analyzed for indication, surgical technique, and postoperative follow-up. In our population and the literature, the majority of the children acquired a functional limb (75%), with few perioperative complications (15%). Fetal morbidity was mainly linked to the consequences of preterm premature rupture of the membranes (38.4%) and preterm birth (34.7 GW). The mortality rate was low (7.7%). This review only describes amniotic bands causing limb constriction, and illustrates that fetoscopic surgery for their release is technically feasible with an acceptable perioperative complication rate. However, the 75% success rate is very likely to be an overestimation of the true success rate. In view of these observations we cannot recommend treatment for cases where the fetus has been extensively affected by the bands. We believe, however, that we could consider this technique for a fraction of amniotic band syndrome cases isolated to the limb constrictions. This kind of surgery should be proposed as a potential treatment for amniotic band syndrome.
Collapse
Affiliation(s)
- Alexandra Gueneuc
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| | - Gihad E Chalouhi
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France, .,National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France, .,Faculty of Medicine, Saint Joseph University, Beirut, Lebanon,
| | - Denisa Borali
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Imen Mediouni
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| | - Julien Stirnemann
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| | - Yves Ville
- Fetal Medicine Unit, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,National Referral Centre for the Management of Complicated Monochorionic Pregnancies, Department of Obstetrics and Fetal Medicine, Necker-Enfants Malades Hospital, Université Paris Descartes, APHP, Paris, France
| |
Collapse
|
8
|
Nassr AA, Erfani H, Fisher JE, Ogunleye OK, Espinoza J, Belfort MA, Shamshirsaz AA. Fetal interventional procedures and surgeries: a practical approach. J Perinat Med 2018; 46:701-715. [PMID: 28599395 DOI: 10.1515/jpm-2017-0015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 04/19/2017] [Indexed: 12/25/2022]
Abstract
Abstract
The identification of congenital birth defects and fetal malformations continues to increase during the antenatal period with improved imaging techniques. Understanding of how to treat specific fetal conditions continues to improve outcomes from these treatment modalities. In an effort to further improvement in this field, we provide a review that begins with a brief background of fetal surgery including the history of fetal surgery, ethics surrounding fetal surgery, and considerations of how to treat the fetus during intervention. A synopsis of the most commonly encountered disease processes treated by fetal intervention/surgery including definitions, treatment modalities, and outcomes following fetal intervention/surgery is then provided. Within the sections describing each disease process, methodology is described that has helped with efficiency and success of procedures performed at our institution.
Collapse
Affiliation(s)
- Ahmed A Nassr
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA.,Women's Health Hospital, Assiut University, Assiut, Egypt
| | - Hadi Erfani
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA
| | - James E Fisher
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA
| | - Oluseyi K Ogunleye
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA
| | - Jimmy Espinoza
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA
| | - Michael A Belfort
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Fetal Center, Houston, TX, USA
| | - Alireza A Shamshirsaz
- Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital Pavilion for Women, 6651 Main Street, Houston, TX 77030, USA,
| |
Collapse
|
9
|
Jensen KK, Oh KY, Kennedy AM, Sohaey R. Intrauterine Linear Echogenicities in the Gravid Uterus: What Radiologists Should Know. Radiographics 2018. [PMID: 29528829 DOI: 10.1148/rg.2018170062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Intrauterine linear echogenicity (ILE) is a common ultrasonographic finding in the gravid uterus and has variable causes and variable maternal and fetal outcomes. Correctly categorizing ILE during pregnancy is crucial for guiding surveillance and advanced imaging strategies. Common causes of ILE include membranes in multiple gestations, uterine synechiae with amniotic sheets, and uterine duplication anomalies. Less common causes include circumvallate placenta, chorioamniotic separation, and hemorrhage between membranes. Amniotic band syndrome is a rare but important diagnosis to consider, as it causes severe fetal defects. Imaging findings enable body stalk anomaly, a lethal defect, to be distinguished from amniotic bands, which although destructive are not necessarily lethal. This review describes the key imaging findings used to differentiate the various types of ILE in pregnancy, thus enabling accurate diagnosis and appropriate patient counseling. Online supplemental material is available for this article. ©RSNA, 2018.
Collapse
Affiliation(s)
- Kyle K Jensen
- From the Department of Diagnostic Radiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OHSU Diagnostic Radiology, L-340, Portland, OR 97239 (K.K.J., K.Y.O., R.S.); and Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (A.M.K.)
| | - Karen Y Oh
- From the Department of Diagnostic Radiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OHSU Diagnostic Radiology, L-340, Portland, OR 97239 (K.K.J., K.Y.O., R.S.); and Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (A.M.K.)
| | - Anne M Kennedy
- From the Department of Diagnostic Radiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OHSU Diagnostic Radiology, L-340, Portland, OR 97239 (K.K.J., K.Y.O., R.S.); and Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (A.M.K.)
| | - Roya Sohaey
- From the Department of Diagnostic Radiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, OHSU Diagnostic Radiology, L-340, Portland, OR 97239 (K.K.J., K.Y.O., R.S.); and Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah (A.M.K.)
| |
Collapse
|
10
|
Kabagambe SK, Lee CJ, Goodman LF, Chen YJ, Vanover MA, Farmer DL. Lessons from the Barn to the Operating Suite: A Comprehensive Review of Animal Models for Fetal Surgery. Annu Rev Anim Biosci 2017; 6:99-119. [PMID: 29237141 DOI: 10.1146/annurev-animal-030117-014637] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The International Fetal Medicine and Surgery Society was created in 1982 and proposed guidelines for fetal interventions that required demonstrations of the safety and feasibility of intended interventions in animal models prior to application in humans. Because of their short gestation and low cost, small animal models are useful in early investigation of fetal strategies. However, owing to the anatomic and physiologic differences between small animals and humans, repeated studies in large animal models are usually needed to facilitate translation to humans. Ovine (sheep) models have been used the most extensively to study the pathophysiology of congenital abnormalities and to develop techniques for fetal interventions. However, nonhuman primates have uterine and placental structures that most closely resemble those of humans. Thus, the nonhuman primate is the ideal model to develop surgical and anesthetic techniques that minimize obstetrical complications.
Collapse
Affiliation(s)
- Sandra K Kabagambe
- University of California, Davis Health, Sacramento, California 95817, USA; , , , , ,
| | - Chelsey J Lee
- University of California, Davis Health, Sacramento, California 95817, USA; , , , , ,
| | - Laura F Goodman
- University of California, Davis Health, Sacramento, California 95817, USA; , , , , ,
| | - Y Julia Chen
- University of California, Davis Health, Sacramento, California 95817, USA; , , , , ,
| | - Melissa A Vanover
- University of California, Davis Health, Sacramento, California 95817, USA; , , , , ,
| | - Diana L Farmer
- University of California, Davis Health, Sacramento, California 95817, USA; , , , , ,
| |
Collapse
|
11
|
Abstract
Fetal surgery corrects severe congenital anomalies in utero to prevent their severe consequences on fetal development. The significant risk of open fetal operations to the pregnant mother has driven innovation toward minimally invasive procedures that decrease the risks inherent to hysterotomy. In this article, we discuss the basic principles of minimally invasive fetal surgery, the general history of its development, specific conditions and procedures used to treat them, and the future of the field.
Collapse
Affiliation(s)
- Claire E Graves
- Department of Surgery, University of California, San Francisco, 550 16th Street 5th Floor UCSF Mail Stop 0570, San Francisco, CA 94158-2549, USA
| | - Michael R Harrison
- University of California, San Francisco, 550 16th Street 5th Floor UCSF Mail Stop 0570, San Francisco, CA 94158-2549, USA
| | - Benjamin E Padilla
- Division of Pediatric Surgery, Department of Surgery, University of California, San Francisco, 550 16th Street 5th Floor UCSF Mail Stop 0570, San Francisco, CA 94158-2549, USA.
| |
Collapse
|
12
|
Lafitte AS, Verspyck E, Jeanne Pasquier C, Dolley P, Dreyfus M, Benoist G. Pseudoamniotic Band Syndrome After Fetoscopic Laser Ablation of Placental Anastomoses for Twin-Twin Transfusion Syndrome: Two Case Reports and Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:2373-2377. [PMID: 28736902 DOI: 10.1002/jum.14295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 03/06/2017] [Accepted: 03/11/2017] [Indexed: 06/07/2023]
Abstract
Pseudoamniotic band syndrome is a rare complication that occurs after invasive procedures for complicated monochorionic twins. We report 2 cases of intrauterine recipient fetal death after laser therapy for twin-twin transfusion syndrome due to umbilical cord constriction by the amniotic band.
Collapse
Affiliation(s)
- Anne Sophie Lafitte
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Centre Hospitalier Universitaire de Caen, Caen, France
- Universitaire de Caen Normandie, Caen, France
| | - Eric Verspyck
- Service de Gynécologie Obstétrique, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | | | - Patricia Dolley
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Michel Dreyfus
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Centre Hospitalier Universitaire de Caen, Caen, France
- Universitaire de Caen Normandie, Caen, France
| | - Guillaume Benoist
- Service de Gynécologie Obstétrique et Médecine de la Reproduction, Centre Hospitalier Universitaire de Caen, Caen, France
- Universitaire de Caen Normandie, Caen, France
| |
Collapse
|
13
|
Alrabai HM, Farr A, Bettelheim D, Weber M, Farr S. Prenatal diagnosis of congenital upper limb differences: a current concept review. J Matern Fetal Neonatal Med 2016; 30:2557-2563. [PMID: 27809626 DOI: 10.1080/14767058.2016.1256989] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Congenital upper limb differences are frequently associated with complex syndromes. Ultrasonography is considered as the first-line diagnostic modality, and fetal MRI can be useful to further evaluate ill-defined areas. Genetic and non-invasive prenatal testing help to identify the underlying genetic disorder. The diagnostic assessment is a multidisciplinary task that should involve early prenatal consultations with specialists involved in case management and treatment planning. Obstetricians, geneticists, radiologists, psychologists and dedicated surgeons are needed to provide good parental education, prenatal and postnatal care, and successful outcomes. The purpose of this review is to provide an overview of the clinicopathologic background, current diagnostic and imaging procedures in affected fetuses.
Collapse
Affiliation(s)
- Hamza M Alrabai
- a Department of Orthopaedics , King Saud University , Riyadh , Saudi Arabia
| | - Alex Farr
- b Department of Obstetrics and Gynaecology , Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna , Vienna , Austria , and
| | - Dieter Bettelheim
- b Department of Obstetrics and Gynaecology , Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna , Vienna , Austria , and
| | - Myriam Weber
- b Department of Obstetrics and Gynaecology , Division of Obstetrics and Feto-Maternal Medicine, Medical University of Vienna , Vienna , Austria , and
| | - Sebastian Farr
- c Department of Pediatric Orthopaedics and Adult Foot and Ankle Surgery , Orthopaedic Hospital Speising , Vienna , Austria
| |
Collapse
|
14
|
Mathis J, Raio L, Baud D. Fetal laser therapy: applications in the management of fetal pathologies. Prenat Diagn 2015; 35:623-36. [DOI: 10.1002/pd.4587] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/21/2015] [Accepted: 02/26/2015] [Indexed: 12/23/2022]
Affiliation(s)
- Jérôme Mathis
- Swiss Fetal Laser Group; University Hospital of Bern, University Hospital of Lausanne CHUV; Lausanne Switzerland
| | - Luigi Raio
- Swiss Fetal Laser Group; University Hospital of Bern, University Hospital of Lausanne CHUV; Lausanne Switzerland
| | - David Baud
- Swiss Fetal Laser Group; University Hospital of Bern, University Hospital of Lausanne CHUV; Lausanne Switzerland
| |
Collapse
|
15
|
Rodríguez González ZI, Soriano Padilla F. [Complex of amniotic deformities, adhesions, mutilations: Endless debate]. BOLETIN MEDICO DEL HOSPITAL INFANTIL DE MEXICO 2015; 72:159-168. [PMID: 29421497 DOI: 10.1016/j.bmhimx.2015.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 06/23/2015] [Accepted: 06/23/2015] [Indexed: 11/28/2022] Open
Abstract
Amniotic deformities, adhesions, mutilations (ADAM) complex is a broad heterogeneous spectrum of congenital anomalies. ADAM complex is characterized by constriction rings, amputation of fingers or limbs and the presence of the amniotic band. However, it may also involve craniofacial disruptions, body wall defects and internal organ abnormalities. The aim of this review is to present the results found in regard to ADAM complex from its historical background, clinical manifestations, epidemiology, etc. In particular, our attention was focused on demonstrating the varying etiopathogenesis theories of ADAM complex and their contradictions. The study was conducted using the databases of PubMed, EBSCO host, Ovid, SpringerLink, Scopus, nature.com, JAMA and ScienceDirect with the following keywords for the search: "amniotic band syndrome", "amniotic band sequence", "Streeter dysplasia", "ADAM complex". In this study we used 22 full-text articles. Patients with ADAM complex require a complete pre- and postnatal evaluation to integrate the diagnosis and to decide on timely treatment. It is important for clinicians and surgeons to possess knowledge of this entity. Further research is necessary to establish a nosological basis.
Collapse
Affiliation(s)
| | - Fernando Soriano Padilla
- Cirugía Maxilofacial Pediátrica, Unidad de Medicina de Alta Especial, Hospital de Pediatría, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México D.F., México
| |
Collapse
|
16
|
Complete chorioamniotic membrane separation with constrictive amniotic band sequence and partial extra-amniotic pregnancy: serial ultrasound documentation and successful fetoscopic intervention. J Perinatol 2014; 34:941-4. [PMID: 25421128 DOI: 10.1038/jp.2014.159] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/23/2014] [Accepted: 07/07/2014] [Indexed: 11/08/2022]
Abstract
Chorioamniotic membrane separation (CMS) comprises cases of spontaneous and iatrogenic detachment between the amniotic and chorionic membranes, with various fetal outcomes due to possible complications, particularly the formation of constrictive amniotic bands and preterm rupture of membranes. In the absence of mandatory management standards conservative monitoring is the most reported approach. In the case we present here, close sonographic surveillance afforded us the opportunity to observe the process from CMS to amnion rupture with the formation of constrictive amniotic bands and threatened cord impairment via constrictive margins of the amniotic sac. Despite the complicated background of reduced membranous layers in ruptured CMS, we performed a successful fetoscopic intervention with band release at 24 weeks' gestation and the pregnancy was prolonged to 34 weeks under close monitoring.
Collapse
|
17
|
Derderian SC, Iqbal CW, Goldstein R, Lee H, Hirose S. Fetoscopic approach to amniotic band syndrome. J Pediatr Surg 2014; 49:359-62. [PMID: 24528986 DOI: 10.1016/j.jpedsurg.2013.05.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 05/14/2013] [Accepted: 05/14/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Amniotic band syndrome (ABS) is an uncommon complication of pregnancy that can result in fetal demise. METHODS We present our experience with fetoscopic amniotic band release. RESULTS Five patients underwent fetoscopic amniotic band release for preoperatively diagnosed ABS involving at least one extremity. Four of five patients were found to have involvement of the umbilical cord at the time of fetoscopy. One of these four did not have the band released and underwent fetal demise at 24 weeks. All four survivors had good functional outcomes of affected limbs. Two patients developed membrane separation and had preterm deliveries at 32 weeks gestation whereas the other two carried to term. No maternal complications were noted. CONCLUSIONS Fetoscopic amniotic band release is safe. Umbilical cord involvement is difficult to assess preoperatively, but when it is present should be treated to reduce the risk of fetal demise.
Collapse
Affiliation(s)
- S Christopher Derderian
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA
| | - Corey W Iqbal
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA
| | - Ruth Goldstein
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Radiology, the University of California, San Francisco, CA 94143-0570, USA
| | - Hanmin Lee
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA
| | - Shinjiro Hirose
- Fetal Treatment Center, the University of California, San Francisco, CA 94143-0570, USA; Department of Surgery, the University of California, San Francisco, CA 94143-0570, USA.
| |
Collapse
|
18
|
Ferreira CR, Lima CFP, de Melo AMAGP. Preventing misdiagnosis in amniotic band sequence: a case report. AUTOPSY AND CASE REPORTS 2013; 3:15-22. [PMID: 31528593 PMCID: PMC6671882 DOI: 10.4322/acr.2013.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Accepted: 03/05/2013] [Indexed: 11/30/2022] Open
Abstract
Amniotic band sequence (ABS) is an uncommon and heterogeneous congenital disorder caused by entrapment of fetal parts by fibrous amniotic bands, causing distinctive structural abnormalities involving limbs, trunk, and craniofacial regions. The incidence ranges between 1/1200 and 1/15,000 live births, but is higher in stillbirths and previable fetuses. The intrinsic theory attributes the constriction band syndrome as an inherent development defect of embryogenesis while the extrinsic theory proposes that an early amnion rupture is responsible for the adherent bands. It is also suggested that amputations and constriction rings might be due to vascular disturbances. Anomalies resulting from amniotic bands are quite variable and sometimes may simulate chromosomal abnormalities. The authors report a case of a 36-week-gestation male neonate who lived for 29 hours after a vaginal delivery with an Apgar score of 8/9/9. The mother was primipara, and the prenatal was uneventful except for two episodes of urinary tract infections. The newborn examination depicted multiple anomalies characterized by exencephaly, bilateral labial cleft with distorted nostrils and palate cleft. There was also facial skin tag band, exophthalmos with hypoplasia of the eyelids. The limbs showed distal amputation of the fingers in both hands and feet, oligodactyly associated with syndactyly in the left foot, ring constriction in the right leg, the presence of right hyperextension, and clubfoot. The upper limbs showed length discrepancies. Karyotype analysis was normal at 46 XY. The authors conclude that the recognition of the malformations secondary to ABS is important in genetic counseling to prevent misdiagnosis between chromosomal and secondary disruption disorders.
Collapse
Affiliation(s)
- Cristiane Rúbia Ferreira
- Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | | |
Collapse
|
19
|
Prenatal imaging of amniotic band sequence: utility and role of fetal MRI as an adjunct to prenatal US. Pediatr Radiol 2012; 42:544-51. [PMID: 22134536 DOI: 10.1007/s00247-011-2296-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 10/02/2011] [Accepted: 10/07/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Amniotic band sequence and its US manifestations have been well-described. There is little information, however, regarding the accuracy and utility of fetal MRI. OBJECTIVE To describe the MRI findings in amniotic band sequence and to compare the diagnostic accuracy of MRI and US. MATERIALS AND METHODS Prenatal MRI and US studies were retrospectively reviewed in 14 consecutive pregnancies with confirmed amniotic band sequence. Both studies were evaluated for amniotic band visualization, body part affected, type of deformity, umbilical cord involvement and vascular abnormality. RESULTS Amniotic bands were confidently identified with MRI in 8 fetuses (57%), suggested with MRI in 3 fetuses (21%) and confidently seen by US in 13 fetuses (93%). Neither modality detected surgically proven bands on one fetus. Both techniques were equally able to define the body part affected and the type of deformity. At least one limb abnormality was visualized in all cases and truncal involvement was present in two cases. Cord involvement was identified in seven cases, with one case detected only by MRI. CONCLUSION Fetal MRI is able to visualize amniotic bands and their secondary manifestations and could be complementary to prenatal US when fetal surgery is contemplated.
Collapse
|
20
|
Abstract
Background Fetal surgery, also referred to as in utero, prenatal or intrauterine surgery, consists of treatment of congenital malformations during the fetal period. The idea of treating malformations diagnosed in the course of intrauterine life dates back to 1963, when Lilly performed the first blood transfusion in a fetus. Since then it has been introduced as a treatment option in a series of lethal malformations. Efforts are being made to treat nonlethal malformations by means of fetal surgery. Material/Methods A comprehensive search of the literature using MEDLINE and PubMed between 1925 and February 2009 was performed. Search terms for MEDLINE and PubMed were: fetal surgery, foetal surgery, in utero surgery, prenatal surgery, and in utero treatment. In addition, information was obtained at Web sites of the International Medicine and Surgery Society and the University of California Fetal Treatment Centre. Results Authors’ attention focused on the survey of indications to intrauterine operations. We outline potential directions of its development, quoting the groundwork of the most experienced researchers and clinicians. Moreover, owing to the authors’ interest in plastic surgery, some remarks on the role of intrauterine medicine and surgery in this branch of medicine are made. Conclusions In utero surgery may be regarded as an efficient tool of preventive medicine. It offers some advantages that no other branch of medicine may offer. However, its implementation is more troublesome than in the past, therefore only selected cases may benefit from its advantages. Nevertheless, current tendencies are to include, after thorough evaluation of benefit-risk ratio, some new indications for fetal surgery.
Collapse
Affiliation(s)
- Piotr Wójcicki
- Department of Plastic Surgery, Wrocław Medical University, Polanica-Zdroj, Poland
| | | |
Collapse
|
21
|
Abstract
Therapeutic techniques for in utero release of amniotic bands have relied on transecting instruments. We present an additional technique, blunt dissection, to release a constriction band in utero. The lower extremity that had detectable abnormalities during prenatal ultrasound had improved outcome after blunt in utero release of the amniotic band compared to the contralateral (control) leg. These findings support two conjectures: first, the degree of band adherence to the fetus is an important factor influencing the surgical approach to in utero lysis of the bands; second, that in utero release of constriction bands can result in improvement in outcome.
Collapse
Affiliation(s)
- Raymen Assaf
- Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, California 90027, USA
| | | | | |
Collapse
|
22
|
Richter J, Wergeland H, DeKoninck P, De Catte L, Deprest JA. Fetoscopic release of an amniotic band with risk of amputation: case report and review of the literature. Fetal Diagn Ther 2012; 31:134-7. [PMID: 22248756 DOI: 10.1159/000335026] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Accepted: 11/10/2011] [Indexed: 11/19/2022]
Abstract
Amniotic bands can cause limb amputation as well as intrauterine fetal demise. Fetoscopic release of amniotic bands has been shown to rescue limb function. Herein, we describe an interesting case of an amniotic band wrapped around the right forearm as well as the umbilical cord, which was released by fetoscopy. Following the procedure, the blood flow in the forearm was restored and the edema gradually reduced. Full functionality of the arm was confirmed after birth, though the esthetic problem of the imprint of the band on the arm persisted. Furthermore, we review the available literature regarding fetoscopic interventions in amniotic band syndrome.
Collapse
Affiliation(s)
- Jute Richter
- Department of Obstetrics and Gynaecology, University Hospitals of Leuven, Leuven, Belgium
| | | | | | | | | |
Collapse
|
23
|
Minimally invasive fetoscopic interventions: an overview in 2010. Surg Endosc 2010; 24:2056-67. [DOI: 10.1007/s00464-010-0879-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2009] [Accepted: 08/14/2009] [Indexed: 10/19/2022]
|