Amniotic bands: Are they all threat for the fetus?

ABSTRACT

Amniotic band syndrome [ABS] or amniotic band disruption is a common cause of sporadic miscellaneous fetal malformation involving limbs, trunk and the craniofacial region. Diagnosis is mainly suspected by ultrasound imaging, where the fetus is seen attached to the amniotic bands. Clinical manifestation is variable from minor constriction rings to fetal or neonatal demise secondary to severance of the umbilical cord or the associated malformation. Therefore, management options vary depending on the associated anomalies. The aim of this report is to highlight this condition, emphasize that subsets of amniotic bands exist which do not pose a threat to the fetus. Prospective study. Ultrasound unit in the Department of Obstetrics and Gynaecology, Salmaniya Medical Complex, Kingdom of Bahrain. Patients with suspected diagnosis of amniotic bands by ultrasound scanning during the study period [January 2005 to December 2007] were followed up till delivery to confirm the diagnosis. Patients Characteristic, clinical presentation, gestational age at the time of presentation, ultrasound images and outcome were reviewed. Three patients were encountered during the study period. The first patient was twenty years old primigravida, while the other two were middle age multiparous ladies. The clinical presentations were variable, however, they all presented with hydramnios. Two cases had typical severe malformations with fetal demise in the neonatal period. The third presented with only amniotic bands demonstrated in the scan but no fetal attachment, which had good outcome. Amniotic band syndrome is a common cause of sporadic and bizarre form of fetal malformation. An isolated finding exists where the amniotic band floats freely in the amniotic fluid and do not attach to the fetal parts. These pose no threat for the fetus. We are reporting three cases of Amniotic bands. The first two cases were the typical presentation of Amniotic band syndrome; whereas the third case highlights the possibility that a subset of amniotic sheets exist that do not disturb the fetus