Early amnion integrity impairment and amniotic band syndrome: diagnosis and pregnancy management tactics
Objective. To optimize diagnosis and pregnancy management tactics, including intrauterine correction, in early amnion integrity impairment and amniotic band syndrome (ABS).Malmberg O.L., Kurtser M.A., Bugerenko A.E., Zvereva A.V., Sukhanova D.I.
Subjects and methods. Fetal anatomical structures were assessed in 11 pregnant women with signs of early amnion integrity impairment at less than 14 weeks’ gestation, as well as in 5 patients with signs of ABS in the second trimester of pregnancy. The investigation was conducted on Voluson E8 and Voluson E10 expert ultrasound systems using convex and intracavitary transducers.
Results. Early amnion integrity impairment was detected in 11 pregnant women at 10–14 weeks’ gestation. At the same time, major malformations were noted in 6 fetuses, while the anatomical structures were intact in five. Follow-up study revealed that three of them had malformations as ABS or lower extremity deformities formed at 5–16 weeks of pregnancy. The bands could be successfully dissected in utero by fetoscopic surgery in two of the five cases of ABS at 18 weeks of gestation.
Conclusion. Timely detection and correct interpretation of fetal malformations and developmental anomalies related to the early amnion rupture spectrum of defects make it possible to optimize pregnancy management tactics and, in some cases, to prevent more severe consequences of this pathological condition.
Keywords
amniotic band syndrome
early amnion rupture
fetoscopy
balloon impasse sign
References
- Moerman P., Ftyns J.P., Vandenberghe K., Lauweryns J.M. Constrictive amniotic bands, amniotic adhesion, and limb-body wall complex: discrete disruption sequences with pathogenic overlap. Am. J. Med. Genet. 1992; 42(4): 470-9. https://dx.doi.org/10.1002/ajmg.1320420412.
- Gaizer D.C., Hirzel A.C., Salgal G., Brcic I., Khanlari M., Rosenberg A.E. Possible genetic origin of limb-body wall complex. Fetal Pediatr. Pathol. 2015; 34(4): 257-70. https://dx.doi.org/10.3109/15513815.2015.1055021.
- Opitz J.M., Johnson D.R., Gilbert-Barness T.F. ADAM “sequence” part II: hypothesis and speculation. Am. J. Med. Genet. A. 2015; 167A(3): 478-503. https://dx.doi.org/10.1002/ajmg.a.36937.
- Cingini P., Giotlandino C., Padula F., Dugo N., Cafà E.V., Spata A. Epidemiology and risk factors of amniotic band syndrome, or ADAM sequence. J. Prenat. Med. 2012; 6(4): 59-63.
- Михайлов А.В., Романовский А.Н., Каштанова Т.А., Кянксеп А.Н., Кузнецов А.А., Шлыкова А.В., Кянксеп И.В., Мовчан В.Е., Базаров И.Р. Синдром амниотических тяжей: клинический случай и обзор литературы. Акушерство и гинекология Санкт-Петербурга. 2018; 3-4: 20-4. [Mikhailov A.V., Romanovsky A.N., Kashtanova T.A. et al. Amniotic cord syndrome: a clinical case and literature review. Obstetrics and gynecology of Saint Petersburg. 2018; 3-4: 20-2. (in Russian)].
- Dabkowska S., Kucinska-Chahwan A., Beneturska A., Ilnicka A., Nowakowska B., Panek G. et al. Prenatal diagnosis and clinical significance of cephalocele - a single institution experience and literature review. Prenat. Diagn. 2020; 40(5): 612-7. https://dx.doi.org/10.1002/pd.5654.
- Proffitt E., Phillips M., DeMauro C., Conde K., Powell J. Ultrasonographic diagnosis of intrauterine fetal decapitation secondary to amniotic band sequence: a case report. J. Emerg. Med. 2016; 5(3): e129-31. https://dx.doi.org/ 10.1016/j.jemermed.2015.11.007.
- Gueneuc A., Chalouhi G.E., Boradi D., Mediouni I., Stirnemann J., Ville Y. Fetoscopic release of amniotic band causing limb constriction: case series and review of the literature. Fetal Diagn. Ther. 2019; 46(4): 246-56. https://dx.doi.org/ 10.1159/000495505.
Received 09.06.2020
Accepted 18.09.2020
About the Authors
Olga L. Malmberg, M.D., PhD, associate Professor of the Department of ultrasound in the RMAPO, member of the ISUOG-international society of ultrasound doctors in obstetrics and gynecology, ultrasound diagnostics doctor at the MD GROUP Clinical hospital. Tel.: +7(916)512-82-91. E-mail: malmberg.olga@gmail.com.117638, Russia, Moscow, Nakhimovsky Ave., 21.
Mark A., Kurtser, academician of the Russian Academy of Sciences, professor, MD, Head of the Department of Obstetrics and Gynecology of N.I. Pirogov Russian National Research Medical University, CEO of the Group of Companies «Mother and Child». E-mail: m.kurtser@mcclinics.ru.
117997, Russia, Moscow, Ostrovityanova str., 1.
Andrey Ye. Bugerenko, M.D, PhD, associate Professor of the Department of obstetrics and gynecology, faculty of fundamental medicine, M.V. Lomonosov Moscow State University; Moscow research and educational center of M.V. Lomonosov Moscow State University; obstetrician-gynecologist, Center for family planning and reproduction. Tel.: +7(499)268-55-33; +7(916)688-45-13. E-mail: jeddit@yandex.ru.
119991, Russia, Moscow, GSP–1, Leninskie Gory, 1, p. 51; 119192, Russia, Moscow, Lomonosovsky prospekt, 27, build. 10; 117209, Russia, Moscow, Sevastopol Ave., 24A.
Alexandra V. Zvereva, M.D., PhD, head of the obstetric Department of pregnancy pathology, obstetrician-gynecologist, LLC “HAVEN “(Lapino Clinical hospital,)
the “Mother and child” group of companies. Tel.: +7(916)688-45-13. E-mail: Dr-zvereva@yandex.ru.
143081, Russia, Moscow region, Lapino, 1st Uspenskoe sh., 111.
Daria I. Sukhanova, assistant of the Department of obstetrics and gynecology faculty of fundamental medicine, M.V. Lomonosov Moscow State University; obstetrician-gynecologist, MD GROUP Clinical hospital. Tel.: +7(499)268-55-33; +7(985)728-48-05. E-mail: dashenka-sukhanova@yandex.ru.
119991, Russia, Moscow, GSP–1, Leninskie Gory, 1, p. 51; 117209, Russia, Moscow, Sevastopol Ave., 24-1.
For citation: Malmberg O.L., Kurtser M.A., Bugerenko A.E., Zvereva A.V., Sukhanova D.I. Early amnion integrity impairment and amniotic band syndrome: diagnosis and pregnancy management tactics.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2020; 10: 148-155 (in Russian).
https://dx.doi.org/10.18565/aig.2020.10.148-155
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