Ultrasound findings in Pseudoamniotic band syndrome after fetoscopic surgery: Antenatal description of three cases and review of literature

J Gynecol Obstet Hum Reprod. 2021 Nov;50(9):102178. doi: 10.1016/j.jogoh.2021.102178. Epub 2021 Jun 7.

Abstract

Introduction: Pseudoamniotic Bands Syndrome (PABS) was described as iatrogenic complication from in utero procedure as fetoscopy.

Objective: The aim of our study was to identify the ultrasound findings in PABS diagnosed prenatally METHODS: First, we reported cases of PABS following fetoscopic surgery that were diagnosed prenatally in our institution. We collected all ultrasound data with fetal and neonatal issues. Then, a literature review was conducted by searching the Medline and Cochrane Library computer databases until 2020 to find publications that involve PABS diagnosed prenatally or postnatally. The following keywords were selected and combined: "pseudoamniotic bands syndrome", "fetoscopy", "fetal surgery".

Results: We collected three cases of PABS diagnosed prenatally in our center following fetoscopic procedures for complicated monochorionic pregnancies. Among these cases, we reported the following ultrasound findings: floating membrane, amniotic bands, striction of limbs, perilesional edema, reduced member size and anomalies of Doppler flow. Including our cases, we reported 23 published PABS of which eight (35%) were prenatally diagnosed. When it was diagnosed, mean GA at PABS diagnosis was 23 weeks (mean interval from fetoscopic to diagnosis was 4 weeks). Three fetoscopic release of amniotic bands were described. The principal parts affected were the limbs, more particularly the extremities.

Conclusion: PABS was accessible to an antenatal diagnosis, as well as ABS. Although it is a rare complication of fetoscopic surgery, ultrasound examinations after procedure should focus on PABS signs to improve prognosis of the neonates.

Keywords: Fetoscopy; Prenatal ultrasound; Pseudoamniotic band syndrome.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Amniotic Band Syndrome / diagnosis
  • Amniotic Band Syndrome / etiology*
  • Female
  • Fetoscopy / adverse effects*
  • Fetoscopy / methods
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Pregnancy
  • Ultrasonography / methods*