Pseudoamniotic band syndrome: a rare complication of monochorionic twins with fetofetal transfusion syndrome treated by laser coagulation

Winer, Norbert; Salomon, Laurent; Essaoui, M.; Nasr, B.; Bernard, J; Ville, Y.

doi:10.1016/j.ajog.2007.09.030

Cited by 51 publications

(66 citation statements)

References 21 publications

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“…Inadvertent septostomy has been reported to occur in 7% of cases after fetoscopic laser therapy, and is associated with an increased risk of adverse perinatal outcome and PABS [17]. The diagnosis of PABS was made prenatally in only 2 of 8 cases (25%) [1], highlighting the poor sensitivity of prenatal diagnosis for this condition. In our case, ultrasonographic diagnosis of the situation could not be made prenatally as the abnormalities were subtle.…”

Section: Discussionmentioning

confidence: 99%

“…In a smaller retrospective study by Habli et al [16] involving 152 patients with TTTS who were treated with SFLP at 16–26 weeks of gestation, 5 cases (3.3%) had PABS. Winer et al [1] in a prospective study of 438 consecutive TTTS cases treated at 15–26 weeks of gestation reported PABS in 8 cases (1.8%). All the cases described by Winer survived the perinatal period and the affected twin was always the former recipient.…”

Section: Discussionmentioning

confidence: 99%

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Limb Constriction Secondary to Pseudoamniotic Band Syndrome after Selective Fetoscopic Laser Surgery: Report of a Case with a Favorable Outcome

Rodrigues

Araújo²,

Carvalho³

et al. 2012

Fetal Diagn Ther

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Pseudoamniotic band syndrome (PABS) is an iatrogenic complication that causes entanglement of fetal parts in a constrictive sheet of detached or ruptured amniotic membrane after an invasive procedure, namely amniocentesis, amnioreduction or septostomy in twins. The incidence and risk factors for PABS after fetoscopy-guided laser have not been documented [Winer et al.: Am J Obstet Gynecol 2008;198:393.e1–393.e5]. We report a case of monochorionic biamniotic twin pregnancy submitted to selective fetoscopic laser photocoagulation for twin-to-twin transfusion syndrome at 16 weeks of gestation. The procedure was complicated by the death of one of the fetuses at 24 weeks of gestation. Moreover, the surviving twin was diagnosed postnatally with pseudoamniotic band syndrome, presenting with affected limbs. The newborn was submitted to surgical correction of these lesions with a successful outcome and was discharged on day 15.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Limb Constriction Secondary to Pseudoamniotic Band Syndrome after Selective Fetoscopic Laser Surgery: Report of a Case with a Favorable Outcome

Rodrigues

Araújo²,

Carvalho³

et al. 2012

Fetal Diagn Ther

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“…Winer et al recently reported eight cases of amniotic band syndrome among 438 fetoscopic laser surgeries for TTTS in monochorionic diamniotic twins (1.8%). In these cases only the extremities were involved 9 .…”

Section: Fetal Abdominal Scarring Caused By the Umbilical Cord Of A Cmentioning

confidence: 99%

Prenatal sonographic features of complete covered cloacal exstrophy

Ono

Kikuchi

Takagi

et al. 2009

Ultrasound in Obstet & Gyne

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“…24,26 Além do mais, a septostomia acidental tem sido associada ao aumento das chances de desenvolvimento da síndrome da banda pseudoamniótica, com potencial teórico para constrição e mesmo amputação de membros. 27 A conduta expectante, por sua vez, é uma opção a ser considerada exclusivamente nas pacientes com STFF estágio I. 5 O principal argumento para tal é que somente 10-30% das pacientes conduzidas de forma expectante neste estágio progredirão para formas mais severas da STFF.…”

Section: Figura 1 Número De Casos De Síndrome De Transfusão Fetofetaunclassified

Síndrome de transfusão feto-fetal

Carvalho¹

2015

Revista Hospital Universitário Pedro Ernesto

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59Artigo de revisão Resumo A presente revisão discorre sobre a síndrome de transfusão fetofetal (STFF), patologia rara, que acomete cerca de 10-15% das gestações gemelares monocoriônicas/diamnióticas (MCDA). A mortalidade perinatal da STFF, quando ausente o tratamento antenatal, gira em torno de 90% para ambos os fetos. Observa-se déficit neurológico importante em 50% dos sobreviventes da STFF, como consequência da prematuridade ou do óbito unifetal. A identificação precoce da corionicidade das gestações gemelares permanece um desafio para o correto manuseio das prenhezes MCDA ao longo da gestação. A gravidade desta patologia justifica a organização de serviços de referência especializados para seu diagnóstico e tratamento, apesar da sua relativa raridade. Nas últimas duas décadas a fetoscopia para coagulação a laser das anastomoses placentá-rias se tornou o padrão ouro para o tratamento intrauterino da STFF. Tal dado foi corroborado por um dos únicos ensaios clínicos randomizados realizados na área de cirurgia fetal e por vários estudos prospectivos longitudinais. Ao contrário de outras propostas terapêuticas, como a amniorredução, septostomia e mais raramente o feticídio seletivo, a laserterapia por fetoscopia promove o tratamento da causa patogênica primária da STFF. A conduta expectante pode ser considerada como primeira opção terapêutica nos casos iniciais de STFF (estágio I de Quintero). Resultados recentes identificam uma sobrevida global de 67,4% para ambos os fetos e de 90,6% para pelo menos um dos fetos. Trabalhos recentes também reportam taxas de atraso neurológico menores que 5% em gemelares tratados através da laserterapia.Descritores: Transfusão fetofetal; Gravidez de gêmeos; Gravidez múltipla; Fetoscopia; Fotocoagulação a laser. Abstract Twin twin transfusion syndromeThe present review discusses the Twin Twin Transfusion Syndrome (TTTS), a rare disease that affects about 10-15% of monochorionic/ diamniotic twin pregnancies / diamnióti-cas (MCDA). The perinatal mortality of TTTS, when absent antenatal treatment, is around 90% for both fetuses. Significant neurological deficit is observed in 50% of survivors of TTTS, as a result of prematurity or death of the co-twin. Early identification of chorionicity of twin pregnancies remains a challenge for the correct management of MCDA pregnancies throughout gestation. The severity of this condition justifies the organization of specialized reference centers for its diagnosis and treatment, despite the relative rarity. In the last two decades fetoscopy for laser coagulation of placental anastomoses has become the gold standard for the intraute- rine treatment of TTTS. This finding was corroborated by a randomized clinical trial, rare in the fetal surgery area, and for several prospective longitudinal studies. Unlike other therapeutic approaches such as amnioreduction, septostomy, and more rarely selective feticide, fetoscopy for laser therapy promotes the treatment of primary pathogenic cause of TTTS. Expectant management may be considered as the first ther...

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Pseudoamniotic band syndrome: a rare complication of monochorionic twins with fetofetal transfusion syndrome treated by laser coagulation

Cited by 51 publications

References 21 publications

Limb Constriction Secondary to Pseudoamniotic Band Syndrome after Selective Fetoscopic Laser Surgery: Report of a Case with a Favorable Outcome

Limb Constriction Secondary to Pseudoamniotic Band Syndrome after Selective Fetoscopic Laser Surgery: Report of a Case with a Favorable Outcome

Prenatal sonographic features of complete covered cloacal exstrophy

Síndrome de transfusão feto-fetal

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