Two case reports: Early detection of amniotic band syndrome by adhesion between hand and umbilical cord at 11 to 14 weeks' gestation.

Zihan Niu,Yunshu Ouyang,Hua Meng,Yixiu Zhang,Xiaoyan Zhang,Xining Wu

doi:10.1097/md.0000000000018302

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 ultrasoundInterventions: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.

Highlights

IntroductionAmniotic band syndrome (ABS) with complex etiology is a rare and serious congenital anomaly of the fetus and appendages, in which the fetal body parts are tangled or wrapped by ruptured
Amniotic band syndrome (ABS) with complex etiology is a rare and serious congenital anomaly of the fetus and appendages, in which the fetal body parts are tangled or wrapped by ruptured Editor: N/A.Informed written consent was obtained from the patient for publication of this case report and accompanying images.The authors declared that this study has received no financial support
In our 2 cases of ABS, only the fetal hand adhered to umbilical cord with restricted movement was detected during the first transabdominal-ultrasound examination at 11∼14 gestational weeks, and the floating bands in the amniotic cavity were found 2 to 3 weeks later

Summary

Introduction

Amniotic band syndrome (ABS) with complex etiology is a rare and serious congenital anomaly of the fetus and appendages, in which the fetal body parts are tangled or wrapped by ruptured. Two case reports: early detection of amniotic band syndrome by adhesion between hand and umbilical cord at 11 to 14 weeks’ gestation. In our 2 cases of ABS, only the fetal hand adhered to umbilical cord with restricted movement was detected during the first transabdominal-ultrasound examination at 11∼14 gestational weeks, and the floating bands in the amniotic cavity were found 2 to 3 weeks later. Both fetuses died in the second trimester of pregnancy. As far as we know, this is the first report that ABS in early pregnancy can be characterized by adhesion between fetal hand and umbilical cord with limited movement. The US characteristics and follow-up results were analyzed and summarized

Case 1

Findings

Discussion