Anencephaly associated with amniotic bands: A case report and review of the association

Abstract

Introduction: Anencephaly is a relatively common fatal neuro-developmental disorder. Routine prenatal screening using ultrasound diagnoses the condition frequently and aid in managing the cases appropriately. Anencephaly is characterized by a severe developmental anomaly of the brain and a defective skull. Amniotic band syndrome is a condition associated with multiple congenital anomalies, which are often a consequence of fibrotic amniotic bands extending from the placenta to the fetus. It is a rare association but can be recognized by first trimester or late obstetric ultrasound. Amniotic band syndrome may be associated with anencephaly and often attributed as a causative factor. Apart from the amniotic band syndrome, many other conditions are associated with amniotic bands and the syndrome may be labeled erroneously if only the bands are taken into consideration.Case: A 27-year-old, G2P1 lady at 12 weeks and 2 days gestational age came for a routine ultrasound evaluation. The fetus was found to have a deformity of the head characteristic of anencephaly sequence. Multiple fibrotic bands were seen in the amniotic cavity extending from the placenta towards the fetus side, suspicious of amniotic band syndrome. The pregnancy was subsequently terminated on the patient’s request.Conclusion: The association of anencephaly and amniotic band syndrome is well known and the bands are often responsible for the spectrum of anencephalic anomalies. Asymmetric defects in the skull and brain are the norm in such cases along with multiple defects in the body parts. Both the anomalies are in general severe and may warrant early intervention. More benign amniotic bands like chorioamniotic separation may be encountered in pregnancy and should not be confused with more dangerous amniotic band syndrome. Recognition of amniotic bands is important, as many bands regardless of the etiology were found to be potentially harmful.