Two case reports

Abstract

Rationale: The significant ultrasonic characteristics of amniotic band syndrome (ABS) are the malformations of fetal affected parts and the band-like echoes in amniotic cavity. This article first suggests that the fetal hand adhered to umbilical cord with restricted movement provides some values in the diagnosis of ABS in early gestational weeks especially when the fetal malformation is not obvious and amniotic band is thin and fine.Patient concerns: Two pregnant women had no discomfort and underwent routine ultrasound examination at 11 to 14 gestational weeks.Diagnosis: Only the fetal hand adhered to umbilical cord with restricted movement was detected during the first ultrasound examination at 11∼14 gestational weeks, and the floating band-like echos were detected in the amniotic cavity with follow-up examinations 2 to 3 weeks later. Both of the 2 fetus were diagnosed as ABS by ultrasound Interventions: The two pregnant women underwent the prenatal counseling and were recommended closely follow-up and further examination.Outcomes: Two fetuses died in utero between 17 and 19 weeks. After induction of labor, it was found that the hands and umbilical cord of the fetuses were wrapped by amniotic bands, which was proved pathologically as ABS.Lessons: The adhesion of the fetal hand and umbilical cord is an important ultrasonic sign suggesting ABS with poor prognosis in early pregnancy. We hope that this study can provide some guidance for the early diagnosis of ABS during 11 to 14 week's ultrasound examination.

Amniotic band syndrome leading to severe malformations of the newborn: a case report at Tu Du Hospital, Vietnam, and literature review

“…However, in the second and third trimesters of pregnancy, it is relatively easy to detect the major anomalies of ABS by its characteristic features and restriction of motion. The sequential ultrasonographic examinations, along with restricted fetal movements, help in the correct diagnosis of ABS in utero 6 , 7 . In the present case, the patient was lately admitted to our center after 32 weeks of GA, therefore, we could not detect well the morphological malformation by routine ultrasound scan.…”

“…Amniotic bands floating in the amniotic cavity with one of them attached to the fetal part are a suggestive sign for more investigation. Niu et al 7 described two cases of the fetal hand adhering to the umbilical cord with restricted movement during 11–14 weeks of gestational age (GA) as an early sign for the diagnosis of ABS.…”

Amniotic band syndrome associated with malformation of extremities

“…Amniotic band syndrome can be detected at prenatal ultrasonography by visualizing the amniotic bands attached to fetus 3,5 , constriction rings on extremities, amputations of the fingers or toes and terminal syndactyly 6 . Nevertheless, due to severe oligohydramnios makes prenatal detection difficult.…”

Síndrome de bandas amnióticas

“…El diagnóstico por ultrasonido varía dependiendo de la parte afectada. Se puede evidenciar como un anillo de constricción simple, hasta alteraciones severas tanto morfológicas como funcionales (craneofaciales, del tronco, extremidades y otras áreas) (10) . Ushakov y Lia publicaron en una serie de 28 casos los 4 tipos de características que se pueden presentar para el diagnóstico de esta entidad como son: red amnióti- ca, división del amnios, conexiones del amnios, dificultad para la movilización del feto (11) .…”

“…Sin embargo, en algunos casos no se logra visualizar los ecos generados por las bandas, sobre todo en gestaciones tempranas, lo que hace difícil su diagnóstico. Teniendo en cuenta lo anterior, es importante evaluar tanto la movilidad como la morfología de las extremidades, para un acercamiento al diagnóstico (10) .…”