胎儿双侧胸腔积水行胎儿胸羊膜分流术后的假性羊膜带综合征

Pseudoamniotic Band Syndrome Post Fetal Thoracoamniotic Shunting for Bilateral Hydrothorax.

作者信息

Han Michelle, Afshar Yalda, Chon Andrew H, Scibetta Emily, Rao Rashmi, Meyerson Cherise, Chmait Ramen H

机构信息

a Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology , University of California , Los Angeles, Los Angeles , California , USA.

b University of Southern California, Keck School of Medicine , Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Los Angeles , California , USA.

出版信息

Fetal Pediatr Pathol. 2017 Aug;36(4):311-318. doi: 10.1080/15513815.2017.1313915. Epub 2017 Apr 28.

DOI:10.1080/15513815.2017.1313915

PMID:28453379

Abstract

INTRODUCTION

Pseudoamniotic band syndrome (PABS) occurs iatrogenically after fetal surgery or amniocentesis due to chorioamniotic membrane separation. Separation of the amnion from the chorion can expand to form fibrous amniotic bands that can envelope fetal limbs or the umbilical cord, with consequences ranging from limb constriction to fetal demise.

CASE REPORT

We report a case of bilateral fetal pleural effusions at 27 weeks' gestation treated by bilateral thoracoamniotic shunts. Following shunt placement, the hydrothorax resolved. However, chorioamniotic membrane separation developed resulting in PABS with subsequent umbilical cord strangulation and fetal demise at 32 weeks' gestation.

CONCLUSION

PABS has been previously described in the literature following various fetal interventions. This is the first reported case of pseudoamniotic band syndrome after placement of fetal thoracoamniotic shunts. A high index of suspicion is required to diagnose PABS via postoperative ultrasound. Post intervention chorioamniotic membrane separation warrants close surveillance for sonographic evidence of PABS.

摘要