Fetoscopic Release of Extremity Amniotic Bands With Risk of Amputation

Soldado, Francisco; Useche, María Cristina; Peiró, José L.; Carreras, Elena; Arévalo, Sílvia; Fontecha, César G.; Vélez, Roberto; Barber, Ignasi; Martínez-Ibáñez, Vicente

doi:10.1097/bpo.0b013e31819c405f

Cited by 38 publications

(29 citation statements)

References 11 publications

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“…Membrane rupture, either spontaneous or iatrogenic, appears to account for the majority of cases but congenital anomalies of the amniotic membranes have also been implicated 3 . Regardless of etiology, there is increasing experience with intrauterine release of congenital constrictions and evidence is mounting that this therapy may help save/restore some limb function and morphology 4 . These findings have been confirmed in both animal and human studies 3−9 .…”

Section: Introductionmentioning

confidence: 99%

Perinatal outcome after fetoscopic release of amniotic bands: a single‐center experience and review of the literature

Javadian

Shamshirsaz

Haeri

et al. 2013

Ultrasound in Obstet & Gyne

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Section: Introductionmentioning

confidence: 99%

Perinatal outcome after fetoscopic release of amniotic bands: a single‐center experience and review of the literature

Javadian

Shamshirsaz

Haeri

et al. 2013

Ultrasound in Obstet & Gyne

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“…150 Fetuses that may benefit from amniotic band release by fetoscopy are those with an abnormal flow (compared to the opposite limb or available reference values) in the distal portion of the limb. 150,152,153 The objective of this procedure is to prevent irreversible injuries and have a potentially reconstructible limb post-natally. 153 If diagnosis is made post-natally, the classification proposed by Hennigan and Kuo 115 is used to select the surgery, i.e., an elective and cosmetic surgery for patients with superficial bands that do not affect the lymphatic or circulatory drainage or an emerging treatment for patients with deep bands affecting the anatomical and functional integrity of the site involved.…”

Section: -142mentioning

confidence: 99%

“…150,152,153 The objective of this procedure is to prevent irreversible injuries and have a potentially reconstructible limb post-natally. 153 If diagnosis is made post-natally, the classification proposed by Hennigan and Kuo 115 is used to select the surgery, i.e., an elective and cosmetic surgery for patients with superficial bands that do not affect the lymphatic or circulatory drainage or an emerging treatment for patients with deep bands affecting the anatomical and functional integrity of the site involved. 106 Craniofacial and body wall anomalies should be approached by surgery based on clinical practice guidelines individually for each case.…”

Section: -142mentioning

confidence: 99%

An update on amniotic bands sequence

López-Muñoz

Becerra-Solano

2018

Arch Argent Pediatr

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Amniotic bands sequence is a congenital disorder characterized by craniofacial, body wall, and limb anomalies that may be associated with fetalplacental fibrous bands. Its prevalence has been reported to range from 0.19 to 8.1 per 10 000 births. Different theories have attempted to explain the etiology of amniotic band sequence; however, none has individually been able to support each and every defect observed, so it has been considered to be a multifactorial condition. The (pre-and post-natal) identification of anomalies suggestive of amniotic band sequence is useful for the diagnostic approach and implementation of timely therapeutic interventions favoring the release of the amniotic bands using fetoscopy with recovery of the involved distal limb perfusion, or else the possibility of performing a post-natal surgical repair. It is also helpful to provide genetic counseling. This article offers an update on the epidemiological aspects, etiological theories, risk factors, clinical characteristics, diagnosis (including antenatal diagnosis), genetic counseling, therapeutic approach, and prognosis of amniotic bands sequence.

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“…This allows fetoscopic control of the section of the bands. Alternatively, laser can be used, but that can cause collateral damage [22,23]. It might be very difficult to section the bands entirely as they get entrapped within edematous surrounding structures.…”

Section: Uncommon Fetoscopic Interventionsmentioning

confidence: 99%

The use of endoscopy in fetal medicine

Beck¹,

Pexsters²,

Gucciardo³

et al. 2010

Gynecol Surg

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We aimed to review the state of affairs in the field of embryo-fetoscopy as well as its instrumental requirements. Today, endoscopic procedures of limited complexity are easily possible within the amniotic cavity. Embryoscopy is typically done for diagnostic purposes, such as the demonstration of external anomalies very early in pregnancy and/or obtaining embryonic tissues in recurrent miscarriages. Fetoscopy is the direct visualization of the amniotic cavity from the second trimester onwards. Its principal indications are complications of monochorionic twinning and severe congenital diaphragmatic hernia. There is level I evidence that fetoscopic laser surgery for twintwin-transfusion syndrome is superior over amniodrainage. Fetoscopic endoluminal tracheal occlusion is done for severe diaphragmatic hernia. Whether tracheal occlusion yields better outcomes than expectant management during pregnancies is currently being investigated in a randomized trial. There are a number of less common procedures discussed as well. Overall, maternal risks of embryofetoscopy are minimal. The most frequent complication is rupture of the membranes and as a consequence preterm delivery. Fetal surgery seems safe and has, therefore, become a clinical reality. Although the stage of technical experimentation is over, most interventions remain investigational. Inclusion of patients into trials whenever possible should be encouraged, rather than building up casuistic experience.

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Fetoscopic Release of Extremity Amniotic Bands With Risk of Amputation

Cited by 38 publications

References 11 publications

Perinatal outcome after fetoscopic release of amniotic bands: a single‐center experience and review of the literature

Perinatal outcome after fetoscopic release of amniotic bands: a single‐center experience and review of the literature

An update on amniotic bands sequence

The use of endoscopy in fetal medicine

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