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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.
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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
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2
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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.
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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
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3
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Rives E, Denney JM, Brost BC. A transient finding of fetal head entrapment caught in a uterine synechium or amniotic band. CASE REPORTS IN PERINATAL MEDICINE 2019. [DOI: 10.1515/crpm-2018-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Uterine synechia are bands of fibrous tissue that when seen on prenatal ultrasound are not felt to pose significant risk to a fetus outside of early pregnancy loss. On the contrary, amniotic bands are diagnosed when bands of amniotic tissue are found to entrap and possible amputate involved fetal parts.
Case presentation
Ultrasound imaging demonstrated a twin pregnancy affected by entrapment of twin B’s head in a uterine synechium versus an amniotic band at 11 weeks + 0 days. The entrapment persisted until the second trimester. After a review of still images and video clips with a fetal surgeon, the patient was scheduled for possible fetal surgery. Upon arrival at 16 weeks + 0 days, the entrapment was observed to have spontaneously resolved. The patient experienced preterm premature rupture of membranes at 17 weeks + 6 days, and developed chorioamnionitis at 18 weeks + 5 days. Shortly after diagnosis with chorioamnionitis, she delivered spontaneously at 18 weeks + 5 days. Postnatal hysteroscopy demonstrated uterine synechium at the uterine fundus, which was resected.
Conclusions
This is the first case of fetal head entrapment by a uterine synechium.
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Affiliation(s)
- Edward Rives
- Wake Forest School of Medicine, Department of Obstetrics and Gynecology , Section on Maternal-Fetal Medicine , Winston-Salem, NC , USA
| | - Jeff M. Denney
- Wake Forest School of Medicine, Department of Obstetrics and Gynecology , Section on Maternal-Fetal Medicine , Winston-Salem, NC , USA
| | - Brian C. Brost
- Wake Forest School of Medicine, Department of Obstetrics and Gynecology , Section on Maternal-Fetal Medicine , Winston-Salem, NC , USA
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4
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Management of the Amniotic Band Syndrome with Cleft Palate: Literature Review and Report of a Case. Case Rep Dent 2017; 2017:7620416. [PMID: 28246561 PMCID: PMC5299194 DOI: 10.1155/2017/7620416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2016] [Accepted: 01/05/2017] [Indexed: 11/17/2022] Open
Abstract
Amniotic Band Syndrome (ABS) is a group of congenital malformations that includes the majority of typical constriction rings and limb and digital amputations, together with major craniofacial, thoracic, and abdominal malformations. The syndrome is caused by early rupture of the amniotic sac. Some of the main oral manifestations include micrognathia, hyperdontia, and cleft lip with or without cleft palate, which is present in 14.6% of patients with this syndrome. The purpose of this report was to describe the clinical characteristics and the oral treatment provided to a 6-month-old male patient affected with ABS with cleft lip and palate.
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Allen LM, Silverman RK, Nosovitch JT, Lohnes TM, Williams KD. Constriction Rings and Congenital Amputations of the Fingers and Toes in a Mild Case of Amniotic Band Syndrome. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2016. [DOI: 10.1177/8756479307306522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Lisa M. Allen
- Regional Perinatal Center, State University of New York Upstate Medical University at Syracuse,
| | - Robert K. Silverman
- Regional Perinatal Center, State University of New York Upstate Medical University at Syracuse
| | - John T. Nosovitch
- Regional Perinatal Center, State University of New York Upstate Medical University at Syracuse
| | - Tammy M. Lohnes
- Regional Perinatal Center, State University of New York Upstate Medical University at Syracuse
| | - Kathleen D. Williams
- Regional Perinatal Center, State University of New York Upstate Medical University at Syracuse
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Proffitt E, Phillips M, DeMauro C, Conde K, Powell J. Ultrasonographic Diagnosis of Intrauterine Fetal Decapitation Secondary to Amniotic Band Sequence: A Case Report. J Emerg Med 2016; 50:e129-31. [DOI: 10.1016/j.jemermed.2015.11.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/26/2015] [Accepted: 11/10/2015] [Indexed: 11/15/2022]
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Naqvi ZG, Rao I, Anwer W, Yaseen T. Two-stage release in Streeter's dysplasia. BMJ Case Rep 2015; 2015:bcr-2014-207568. [PMID: 25899511 DOI: 10.1136/bcr-2014-207568] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Streeter's dysplasia is a rare disorder of congenital constricting bands, occurring in 1-10 000 birth, with no sex predilection. In severe cases, it is associated with autoamputation of distal extremities such as fingers and toes. Recent advances have made it possible, in developed countries, to recognise this condition in the prenatal period and to initiate prompt intrauterine management, however, these, being uncommon procedures, need technical advances and experienced hands. In developing countries, recognition of the condition with timely management of primary and associated abnormalities required. We present a case of a 4-month-old child with type IV Streeter's dysplasia associated with right flexible clubfoot, who underwent successful two-stage release of symptomatic constricting bands from bilateral legs.
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Affiliation(s)
- Zohaib Gulzar Naqvi
- Department of General Surgery, Aga Khan University Hospital, Karachi, Sindh, Pakistan
| | - Irfan Rao
- Department of Orthopedics, The Indus Hospital, Karachi, Sindh, Pakistan
| | - Wahid Anwer
- Department of General Surgery, The Indus Hospital, Karachi, Sindh, Pakistan
| | - Tahir Yaseen
- Department of Surgery, The Indus Hospital, Karachi, Sindh, Pakistan
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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
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Turğal M, Ozyüncü O, Yazıcıoğlu A, Onderoğlu LS. Integration of three-dimensional ultrasonography in the prenatal diagnosis of amniotic band syndrome: A case report. J Turk Ger Gynecol Assoc 2014; 15:56-9. [PMID: 24790518 DOI: 10.5152/jtgga.2013.91298] [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: 05/26/2013] [Accepted: 07/25/2013] [Indexed: 11/22/2022] Open
Abstract
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.
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Affiliation(s)
- Mert Turğal
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ozgür Ozyüncü
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Aslıhan Yazıcıoğlu
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Lütfü Sabri Onderoğlu
- Department of Obstetrics and Gynecology, Maternal Fetal Medicine Unit, Hacettepe University Faculty of Medicine, Ankara, Turkey
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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.
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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.
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Affiliation(s)
- Jute Richter
- Department of Obstetrics and Gynaecology, University Hospitals of Leuven, Leuven, Belgium
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Martínez-Payo C, Savirón R, Iglesias E. Diagnóstico ecográfico prenatal de un caso de síndrome de bandas amnióticas. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2010. [DOI: 10.1016/j.gine.2009.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Abstract
Constriction ring syndrome is a congenital anomaly with sometimes devastating consequences. Because of the unknown etiology, treatment is aimed at recovery of function and prevention of the sequelae rather than prevention of the syndrome. This paper aimed to review the theories of the etiology, the features and associated defects, and the operative management of constriction ring syndrome.
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Hüsler MR, Wilson RD, Horii SC, Bebbington MW, Adzick NS, Johnson MP. When is fetoscopic release of amniotic bands indicated? Review of outcome of cases treatedin uteroand selection criteria for fetal surgery. Prenat Diagn 2009; 29:457-63. [DOI: 10.1002/pd.2222] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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15
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Ronderos-Dumit D, Briceño F, Navarro H, Sanchez N. Endoscopic Release of Limb Constriction Rings in utero. Fetal Diagn Ther 2006; 21:255-8. [PMID: 16601333 DOI: 10.1159/000091351] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2004] [Accepted: 05/17/2005] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- D Ronderos-Dumit
- Diagnostico Prenatal, Clínica Materno-Infantil Farallones, Cali, Colombia.
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Armand R, Brenner DS, Sun CCJ. Pathologic quiz case: fetal death at 32 weeks of gestation. Arch Pathol Lab Med 2003; 127:e317-8. [PMID: 12823070 DOI: 10.5858/2003-127-e317-pqcfda] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Ray Armand
- Department of Pathology, University of Maryland School of Medicine, Baltimore, USA.
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