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- Title
Pseudoamniotic Band Syndrome after In Utero Intervention for Twin-to-Twin Transfusion Syndrome: Case Reports and Literature Review.
- Authors
Ting, Yuen Ha; Lao, Terence T.; Law, Kwok Ming; Cheng, Yvonne Kwun Yue; Lau, Tze Kin; Leung, Tak Yeung
- Abstract
Pseudoamniotic band syndrome (PABS) is a rare iatrogenic complication that arises after invasive procedures in monochorionic twins. We report 3 cases of PABS, 2 after fetoscopic laser photocoagulation and 1 after bipolar cord coagulation. Two cases were detected antenatally by ultrasound; out of the two, one underwent successful fetoscopic release of amniotic band, which is the first report in twin pregnancy to our knowledge. In our centre, the incidence of PABS was found to be 2%. There were 25 cases of PABS reported previously, of which 12 cases with clinical details were reviewed together with our 3 cases. The fetal limbs were involved in all 15 cases, leading to constriction or amputation. The umbilical cord was involved in 2 cases, resulting in fetal death in one and pregnancy termination in the other. Antenatal detection of PABS is rare (27%; 4/15) as this requires a high index of suspicion. Serial postoperative targeted ultrasound surveillance of the fetal limbs and umbilical cord is necessary, particularly when features of septostomy or chorioamniotic membrane separation are found. Colour Doppler examination for the perfusion of the affected limb should be performed when PABS is detected. Fetoscopic release of amniotic band could salvage the fetal limb from amputation when impaired blood flow is detected.
- Subjects
DIAGNOSIS of fetal diseases; IATROGENIC diseases in children; LASER photocoagulation; FETAL death -- Risk factors; UMBILICAL cord; OPHTHALMIC surgery; FETOSCOPY; FETAL ultrasonic imaging; NEONATAL diseases; MEDICAL lasers; MULTIPLE pregnancy; PERINATAL death; SURGICAL complications; SYNDROMES; FETOFETAL transfusion; SURGERY
- Publication
Fetal Diagnosis & Therapy, 2016, Vol 40, Issue 1, p67
- ISSN
1015-3837
- Publication type
journal article
- DOI
10.1159/000368601