Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Tochigi, Japan.
Department of Pediatrics, Jichi Medical University, Shimotsuke, Tochigi, Japan.
J Obstet Gynaecol Res. 2022 Jul;48(7):1989-1996. doi: 10.1111/jog.15281. Epub 2022 May 25.
Fetoscopic laser surgery occasionally causes amniotic band syndrome, in which the disrupted amniotic membrane constricts fetal body parts, leading to functional or morphological loss. We report a case of fetal distress at 31 weeks of gestation in the larger surviving twin after fetoscopic laser surgery for selective intrauterine growth restriction, necessitating emergent cesarean section. Physical examination of the infant showed constriction rings caused by a disrupted amniotic membrane on the digits, and the distal part of the right index finger was necrotic because of tight strangulation by an amniotic band with the umbilical cord of the deceased smaller twin. Laboratory data showed severe coagulopathy, and the infant was diagnosed with disseminated intravascular coagulation (DIC). Immediate treatment improved his condition. DIC may have been associated with the necrotic finger, which was strangulated by the umbilical cord of the deceased fetus, because neither maternal coagulopathy nor an underlying neonatal disorder was detected.
羊膜镜激光手术偶尔会导致羊膜带综合征，其中破裂的羊膜会限制胎儿身体部位，导致功能或形态丧失。我们报告了一例选择性宫内生长受限羊膜镜激光手术后 31 周时较大存活双胞胎胎儿窘迫的病例，需要紧急剖宫产。对婴儿的体格检查显示，由于羊膜破裂，手指上有收缩环，并且由于与死亡的较小双胞胎的脐带一起缠绕的羊膜带的紧密勒紧，导致右食指远端坏死。实验室数据显示严重的凝血功能障碍，婴儿被诊断为弥漫性血管内凝血（DIC）。立即治疗改善了他的病情。DIC 可能与被死胎脐带勒紧的坏死手指有关，因为未发现母体凝血功能障碍或新生儿潜在疾病。
