Pseudoamniotic band syndrome (PABS) is a rare iatrogenic complication that occurs after invasive procedures in monochorionic twins for treatment of twin-twin transfusion syndrome (TTTS). Selective fetoscopic laser photocoagulation (SFLP) is a commonly performed procedure for the treatment of severe TTTS that may lead to complications such as preterm labor, preterm rupture of membranes, cerebral lesions and fetal death. PABS has been reported to occur in up to 3% of cases of TTTS treated with laser, leading to limb abnormalities. There are no identifiable risk factors and antenatal detection of PABS is rare, but possible.  Thus, obstetricians should be aware of this possibility in pregnancies treated by laser therapy for TTTS.  The authors report a case of a monochorionic biamniotic twin pregnancy submitted to SFLP for TTTS at 19 weeks of gestation with postnatal diagnosis of PABS, presenting with amputation of a fetal limb.

Lymphangioma is a rare congenital malformation of the lymphatic system that occur in 1 per 6000 live births. The most common site of lymphangioma is the neck (also named cystic hygroma), accounting for 75% of the cases, and it is strongly related to aneuploidies. Axillary location is very rare and appears not to be associated with chromosomal abnormalities. Tumor growth, fetal anemia secondary to intralesional bleeding, hydrops fetalis and shoulder dystocia are possible obstetric complications of this condition. The prognosis is generally good in the absence of abnormal karyotype, fetal hydrops or extension of the lymphangioma to adjacent tissues. Surgical excision or sclerotherapy are the main treatment choices. The authors present a case of a right fetal axillary lymphangioma and review the literature.