Constriction of the Umbilical Cord by an Amniotic Band After Midtrimester Amniocentesis

Abstract

Constriction of the umbilical cord by an amniotic band after previous midtrimester amniocentesis is an extremely rare entity. A case report of fetal asphyxia caused by partial occlusion of the umbilical cord by an amniotic band is presented. Clinical and experimental evidence strongly suggests that the pathogenesis of this defect is related to early rupture of the membranes during gestation with subsequent encirclement and ligation of fetal umbilical cord, or extremities. In this case, formation of the amniotic band caused by midtrimester amniocentesis is strongly suggested. Obstetricians should be aware of this hazardous complication during pregnancy and labor in women who had had a midtrimester amniocentesis.

Complete Chorioamniotic Membrane Separation

“…Of these 15 term deliveries, there were three reported emergency cesarean sections due to fetal distress [6,11]. Another baby was born with mild asphyxia associated with an amniotic band around the cord [17].…”

Extensive Hemorrhagic Chorion‐Amnion Separation After Second‐Trimester Genetic Amniocentesis

“…2 However, in cases of severe separation, it can lead to amniotic band syndrome. Ashkenazi et al 4 presented a case of encirclement and ligation of the fetal umbilical cord secondary to amniotic band formation. Graf et al 5 described umbilical cord blood flow impairment caused by amniotic bands after fetal surgery.…”

“…2-7 Separation of the amnion from the chorion after amniocentesis has been reported previously. [2][3][4] We present a case of extensive hemorrhagic chorion-amnion separation (CAS) at 19 weeks' gestation, 2 days after amniocentesis. It was complicated by preterm premature rupture of membranes at 23 weeks and preterm delivery at 31 weeks.…”

Constriction band syndrome occurring in the setting of in vitro fertilization and advanced maternal age

“…There have been isolated case reports of constriction band syndrome occurring following intrauterine instrumentation, such as amniocentesis (11)(12)(13)(14)(15), chorionic villus sampling (16) or the placement of an intrauterine contraceptive device (10). No clear causative link has been established, but it is suggested that the instrumentation required in the IVF procedure may have played a role.…”

“…In addition, there have been reports associating amniotic band syndrome with maternal trauma, oophorectomy during pregnancy (9), intrauterine contraceptive device (10), amniocentesis (11)(12)(13)(14)(15) and chorionic villus sampling (16).…”